Today I posted an article of a U.S. patient who had an enlarged spleen, skin lesions, and anemia. Blood testing did not reveal bartonellosis, but the spleen was eventually removed and tissue tests revealed the presence of Bartonella bacilliformis. This is a species of Bartonella that is primarily transmitted by sand flies in South America. The patient, it turns out, had visited South America three years earlier. https://madisonarealymesupportgroup.com/2019/11/26/bartonellosis-a-hidden-cause-of-splenomegaly/
Worldwide travel opens the door to insects and pathogens you may not find at home. It’s important to keep track of symptoms & connect them to any travel, making sure to tell your doctor.
The following article shows the various sandflies which look a bit like mosquitoes. Please note they are found in the Southern U.S. as well.
http://entnemdept.ufl.edu/creatures/misc/flies/Lutzomyia_shannoni.htm Full Article Here with pictures
Phlebotomine sand flies are of considerable public health importance because of their ability to transmit several viral, bacterial, and protozoal disease-causing organisms of humans and other animals.
Lutzomyia shannoni Dyar is a proven vector of vesicular stomatitis virus and a suspected vector of visceral leishmaniasis and sand fly fever in Florida. It is one of the more thoroughly studied species of phlebotomine sand flies in North America.
In the United States, it has been found through the southern states from Florida to Louisiana plus Arkansas, Tennessee, South and North Carolina. This species has been found as far north as Maryland and Delaware.
At least 60 species in the Old World genus Phlebotomus or New World genus Lutzomyia are vectors of several vertebrate pathogens, including a group of parasitic flagellate protozoa, Leishmania spp., which may cause cutaneous, visceral or muco-cutaneous Leishmaniasis; the bacterium, Bartonella bacilliformis causing Oroya fever; and several arboviruses causing sand fly fever and vesicular stomatitis (Lane 1993).
University of Florida Entomology & Nematology