Severe hemolytic anemia with fevers followed by hemangioma-type skin lesions; also with hepatosplenomegaly, jaundice, and lymphadenopathy with variable centrilobular necrosis and splenic infarction. Cause is Bartonella infection; vector is sand fly. Condition occurs in Ecuador, Peru, and Columbia. Treatment is streptomycin, penicilin, or chloramphenicol.