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Bartonellosis remains a major problem in Peru, but many contemporary aspects of this disease have not been adequately described. We examined the cases of 145 symptomatic patients in Lima, Peru, in whom bartonellosis was diagnosed from 1969 through 1992, including 68 patients in the acute (hematic) phase and 77 patients in the eruptive (verruga) phase. In(More)
BACKGROUND Bartonella (Rochalimaea) quintana is a fastidious gram-negative bacterium known to cause trench fever, cutaneous bacillary angiomatosis, and endocarditis. Between January and June 1993 in Seattle, we isolated B. quintana from 34 blood cultures obtained from 10 patients not known to be infected with the human immunodeficiency virus (HIV). (More)
In 1993, an outbreak of 10 cases of Bartonella quintana bacteremia occurred among homeless, alcoholic, human immunodeficiency virus (HIV)-negative persons in Seattle. To estimate the prevalence of past exposure B. quintana among this population, a serosurvey was conducted in 1994 among patients at a downtown Seattle clinic. Microimmunofluorescent titers to(More)
Bartonella quintana has episodically emerged as a cause of infection among distinct and diverse populations during the 20th century. The organism was first identified as an important human pathogen during World War I when it caused epidemics of louse-borne trench fever that affected an estimated 1 million troops in Europe (1, 2). Trench fever was(More)
OBJECTIVE To review reports on the transmission of infections by flexible gastrointestinal endoscopy and bronchoscopy in order to determine common infecting microorganisms, circumstances of transmission, and methods of risk reduction. DATA SOURCES Relevant English-language articles were identified through prominent review articles and a MEDLINE search(More)
Rochalimaea quintana and Rochalimaea henselae are closely related, fastidious, gram-negative rickettsiae. Thus far, the spectrum of human Rochalimaea sp. infections has not included endocarditis. We describe a 50-year-old human immunodeficiency virus-positive man who developed endocarditis caused by R. quintana. DNA relatedness studies, which compared our(More)
OBJECTIVE To characterize the etiologic agent (WA1) of the first reported case of babesiosis acquired in Washington State. DESIGN Case report, and serologic, molecular, and epizootiologic studies. SETTING South-central Washington State. PATIENT A 41-year-old immunocompetent man with an intact spleen who developed a moderately severe case of(More)
Immunization with hepatitis B (HBV) vaccine is recommended for all HIV-infected individuals without immunity to HBV. This patient population, however, has relatively poor HBV vaccine responses. Factors associated with this impaired HBV vaccine response in HIV-infected individuals may include older age, uncontrolled HIV replication, and low nadir CD4 cell(More)
A variety of inferential evidence suggests that cytotox-ic T lymphocytes (CTL) can exert substantial anti-HIV activity (1–3), including dramatic reductions in cell-free (4, 5) and cell-associated (6, 7) virus with corresponding increases in CD4 + T cells (5, 8, 9). Still, host-mediated immune responses to HIV generally fail to completely control virus(More)