Bacillary angiomatosis

Bacillary angiomatosis
Classification and external resources
Specialty infectious disease
ICD-10 A44.8 (ILDS A44.85), B20.1 (ILDS B20.11)
ICD-9-CM 088.0
DiseasesDB 2173
eMedicine derm/44
Patient UK Bacillary angiomatosis
MeSH D016917

Bacillary angiomatosis (BA) is a form of angiomatosis associated with bacteria of the Bartonella genus.

Causes

It is caused by either Bartonella henselae or Bartonella quintana.[1]

It can manifest in people with AIDS[3] and rarely appears in those who are immunocompetent.

Presentation

BA is characterised by the proliferation of blood vessels, resulting in them forming tumour-like masses in the skin and other organs.

Symptoms

Cutaneous BA is characterised by the presence of lesions on or under the skin. Appearing in numbers from one to hundreds, these lesions may take several forms:

While cutaneous BA is the most common form of BA, BA can also affect several other parts of the body, such as the brain, bone, bone marrow, lymph nodes, gastrointestinal tract, respiratory tract, spleen and liver. Symptoms vary depending on which parts of the body are affected; for example, those whose livers are affected may have an enlarged liver and fever, while those with osseous BA will experience intense pain in the affected area.

Treatment and prevention

While curable, BA is potentially fatal if not treated.

BA responds dramatically to several antibiotics. Usually, erythromycin will cause the skin lesions to gradually fade away in the next four weeks, resulting in complete recovery. Doxycycline may also be used. However, if the infection does not respond to either of these, the medication is usually changed to tetracycline. If the infection is serious, then a bactericidal medication may be coupled with the antibiotics.

If a cat is carrying Bartonella henselae, then it may not exhibit any symptoms. Cats may be bacteremic for weeks to years, but infection is more common in young cats. Transmission to humans is thought to occur via flea feces inoculated into a cat scratch or bite, and transmission between cats occurs only in the presence of fleas. Therefore, elimination and control of fleas in the cat's environment are key to prevention of infection in both cats and humans.

History

The condition that later became known as bacillary angiomatosis was first described by Stoler and associates in 1983.[4] Being unaware of its infectious origin, it was originally called epithelioid angiomatosis.[5] Following documentation of bacilli in Warthin-Starry stains and by electron microscopy in a series of cases by LeBoit and colleagues, the term bacillary angiomatosis was widely adopted.[6]

See also

References

  1. Koehler JE, Sanchez MA, Garrido CS, et al. (December 1997). "Molecular epidemiology of bartonella infections in patients with bacillary angiomatosis-peliosis". N. Engl. J. Med. 337 (26): 1876–83. doi:10.1056/NEJM199712253372603. PMID 9407154.
  2. Mateen FJ, Newstead JC, McClean KL (July 2005). "Bacillary angiomatosis in an HIV-positive man with multiple risk factors: A clinical and epidemiological puzzle". Can J Infect Dis Med Microbiol. 16 (4): 249–52. doi:10.1155/2005/230396. PMC 2095030Freely accessible. PMID 18159553.
  3. Gasquet S, Maurin M, Brouqui P, Lepidi H, Raoult D (1998). "Bacillary angiomatosis in immunocompromised patients.". AIDS. 12 (14): 1793–803. doi:10.1097/00002030-199814000-00011. PMID 9792380.
  4. Stoler MH, Bonfiglio TA, Steigbigel RT, Pereira M. An atypical subcutaneous infection associated with acquired immune deficiency syndrome. Am J Clin Pathol. 1983 Nov;80(5):714-8
  5. Cockerell CJ, Whitlow MA, Webster GF, Friedman-Kien AE. Epithelioid angiomatosis: a distinct vascular disorder in patients with the acquired immunodeficiency syndrome or AIDS-related complex. Lancet. 1987 Sep 19;2(8560):654-6
  6. LeBoit PE, Berger TG, Egbert BM, Beckstead JH, Yen TS, Stoler MH (1989). "Bacillary angiomatosis. The histopathology and differential diagnosis of a pseudoneoplastic infection in patients with human immunodeficiency virus disease.". Am J Surg Pathol. 13 (11): 909–20. doi:10.1097/00000478-198911000-00001. PMID 2802010.
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