Bartonella bacilliformis
Barton originally identified them as endoglobular structures, which actually were the bacteria living inside red blood cells.For its isolation, special cultures are required, containing complemental soy agar, proteases, peptones, some essential amino acids, and blood.[citation needed] As the sandflies bite, the bacteria are inoculated into the capillaries, where in a variable period of time (around 21 days) they invade the red blood cells producing severe intravascular hemolytic anemia (acute phase of Carrion's disease).[citation needed] When the bacterium invades endothelial cells, it produces the chronic manifestation of the disease known as verruga peruana.The chronic phase is characterized by benign eruptive lesions that are pruritic and bleeding, and other symptoms like malaise and osteoarticular pain.