infectious diseases
Oroya Fever and Verruga Peruana
Oroya fever
Symptoms of Oroya fever include fever and profound anemia, which may be sudden or indolent in onset. The anemia is primarily hemolytic, but myelosuppression also occurs. Muscle and joint pain, severe headache, and often delirium and coma may occur. Superimposed bacteremia caused bySalmonellaor other coliform organisms may occur. Case fatality rates may exceed 50% in untreated patients. Diagnosis of Oroya fever is confirmed by blood cultures. Because Oroya fever is often complicated bySalmonellabacteremia,ciprofloxacinwithceftriaxonefor 14 days is the treatment of choice.Chloramphenicolcombined with a beta-lactam antibiotic (eg,amoxicillin/clavulanate) is an alternative in the event ofciprofloxacinresistance.Azithromycinhas also been used successfully. 