1
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Rotundo S, Tassone MT, Marascio N, Morrone HL, Gigliotti S, Quirino A, Russo A, Matera G, Trecarichi EM, Torti C. A systematic review on antibiotic therapy of cutaneous bacillary angiomatosis not related to major immunocompromising conditions: from pathogenesis to treatment. BMC Infect Dis 2024; 24:380. [PMID: 38589795 PMCID: PMC11000314 DOI: 10.1186/s12879-024-09253-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 03/25/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella spp. that mostly affects people living with HIV (PLWH), transplanted patients and those taking immunosuppressive drugs. Since cBA is mostly related to these major immunocompromising conditions (i.e., T-cell count impairment), it is considered rare in relatively immunocompetent patients and could be underdiagnosed in them. Moreover, antimicrobial treatment in this population has not been previously investigated. METHODS We searched the databases PubMed, Google Scholar, Scopus, OpenAIRE and ScienceDirect by screening articles whose title included the keywords "bacillary" AND "angiomatosis" and included case reports about patients not suffering from major immunocompromising conditions to provide insights about antibiotic treatments and their duration. RESULTS Twenty-two cases of cBA not related to major immunocompromising conditions were retrieved. Antibiotic treatment duration was shorter in patients with single cBA lesion than in patients with multiple lesions, including in most cases macrolides and tetracyclines. CONCLUSIONS cBA is an emerging manifestation of Bartonella spp. infection in people not suffering from major immunocompromising conditions. Until evidence-based guidelines are available, molecular tests together with severity and extension of the disease can be useful to personalize the type of treatment and its duration.
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Affiliation(s)
- Salvatore Rotundo
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
| | - Maria Teresa Tassone
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
| | - Nadia Marascio
- Dipartimento di Scienze della Vita, Unità Operativa Complessa di Microbiologica Clinica, Università "Magna Graecia", Catanzaro, Italy
| | - Helen Linda Morrone
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
| | - Simona Gigliotti
- Dipartimento di Scienze della Vita, Unità Operativa Complessa di Microbiologica Clinica, Università "Magna Graecia", Catanzaro, Italy
| | - Angela Quirino
- Dipartimento di Scienze della Vita, Unità Operativa Complessa di Microbiologica Clinica, Università "Magna Graecia", Catanzaro, Italy
| | - Alessandro Russo
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
- Unità Operativa Complessa di Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria "R. Dulbecco", Catanzaro, Italy
| | - Giovanni Matera
- Dipartimento di Scienze della Vita, Unità Operativa Complessa di Microbiologica Clinica, Università "Magna Graecia", Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
- Unità Operativa Complessa di Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria "R. Dulbecco", Catanzaro, Italy
| | - Carlo Torti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
- Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, Rome, Italy.
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2
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Balaban M, Ioana Nedelcu R, Balmes G, Adela Todorovic T, Brinzea A, Nichita L, Gabriela Popp C, Theodor Andrei R, Andrada Zurac S, Adriana Ion D, Turcu G. Bacillary angiomatosis triggered by severe trauma in a healthy Caucasian patient: A case report. Exp Ther Med 2019; 20:56-60. [PMID: 32508994 DOI: 10.3892/etm.2019.8260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 11/21/2019] [Indexed: 11/05/2022] Open
Abstract
Bacillary angiomatosis represents a cutaneous and systemic infection caused by Bartonella species, typically described in the past in HIV-positive patients or associated with immunodeficiencies. More recent case reports had brought into attention the probability that this entity may manifest in otherwise healthy individuals, triggered by trauma and skin burns. The physiopathology of this neoproliferative process is based on the production of angiogenetic molecules, such as vascular endothelial growth factor (VEGF) and IL-8. In case of an inadequate treatment, the evolution can be fatal, with a systemic dissemination of the abscesses within the gastro-intestinal tract, respiratory tract, brain and bones. The appropriate therapy is with oral erythromycin and doxycycline, but several treatments such as cephalosporins, penicillins, macrolides, aminoglycosides, rifampin, dapsone, ciprofloxacin, have been tried with favorable results. Herein we present the case of a Caucasian patient, seronegative for HIV, who developed multiple vascular papules and nodules on the face, after a severe trauma and which healed after an adequate antibiotic therapy with oral clarithromycin.
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Affiliation(s)
- Mihaela Balaban
- Department of Dermatology, Derma 360° Clinic, Bucharest 011273, Romania.,Department of Biochemistry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest 050474, Romania
| | - Roxana Ioana Nedelcu
- Department of Dermatology, Derma 360° Clinic, Bucharest 011273, Romania.,Department of Pathophysiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest 020105, Romania
| | - Gabriela Balmes
- Department of Dermatology, Colentina Clinical Hospital, Bucharest 020125, Romania
| | | | - Alice Brinzea
- Department of Pathophysiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest 020105, Romania.,Department of Ambulatory, National Institute for Infectious Diseases Prof. Dr. Matei Balș, Bucharest 020105, Romania
| | - Luciana Nichita
- Department of Pathology, Colentina Clinical Hospital, Bucharest 020125, Romania
| | | | | | | | - Daniela Adriana Ion
- Department of Pathophysiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest 020105, Romania
| | - Gabriela Turcu
- Department of Dermatology, Derma 360° Clinic, Bucharest 011273, Romania.,Department of Dermatology, Colentina Clinical Hospital, Bucharest 020125, Romania.,Department of Dermatology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest 050474, Romania
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3
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Eyer-Silva WDA, Soares PEMA, Azevedo MCVMD, Silva GARD, Signorini DJHP, Neves-Motta R, Pinto JFDC, Moura LM, Basílio-de-Oliveira RP, Araujo LFD, Favacho ARDM, Lemos ERS. An unusual case of bacillary angiomatosis in the oral cavity of an AIDS patient who had no concomitant tegumentary lesions - case report and review. Rev Inst Med Trop Sao Paulo 2017; 59:e59. [PMID: 28902296 PMCID: PMC5574626 DOI: 10.1590/s1678-9946201759059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/04/2017] [Indexed: 11/22/2022] Open
Abstract
Bacillary angiomatosis (BA) is an angioproliferative disease of immunocompromised patients that usually presents as vascular tumors in the skin and subcutaneous tissues. It is caused by chronic infections with either Bartonella henselae or B. quintana. Oral cavity BA is exceedingly rare and even rarer without simultaneous cutaneous disease. We report herein the case of a 51-year-old HIV-infected man who presented severe odynophagia and an eroded lesion on the hard palate that progressed to an oronasal fistula. No cutaneous lesions were recorded. Doxycycline led to complete resolution. To the best of our knowledge, only six previous cases of oral BA without tegumentary disease have been previously reported and none of them progressed to fistula.
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Affiliation(s)
- Walter de Araujo Eyer-Silva
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pedro Eugênio Mendes Arena Soares
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcelo Costa Velho Mendes de Azevedo
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Guilherme Almeida Rosa da Silva
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Dario José Hart Pontes Signorini
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rogerio Neves-Motta
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jorge Francisco da Cunha Pinto
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lívia Machado Moura
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rodrigo Panno Basílio-de-Oliveira
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luciana Ferreira de Araujo
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Elba Regina Sampaio Lemos
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Hantaviroses e Rickettsioses, Rio de Janeiro, Rio de Janeiro, Brazil
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4
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Blattner C, Jacobson-Dunlop E, Miller JH, Elston DM. A Case of Bacillary Angiomatosis in a Patient with Pancreatic Adenocarcinoma. J Cutan Pathol 2014; 41:277-80. [DOI: 10.1111/cup.12303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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5
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William BM, Thawani N, Sae-Tia S, Corazza GR. Hyposplenism: A comprehensive review. Part II: Clinical manifestations, diagnosis, and management. Hematology 2013; 12:89-98. [PMID: 17454188 DOI: 10.1080/10245330600938463] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
In the first part of this review, we described the physiological basis of splenic function and hypofunction. We also described the wide spectrum of diseases that can result in functional hyposplenism. In the second part of this review, we will be discussing the clinical picture, including complications, diagnostic methods, and management of hyposplenism.
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Affiliation(s)
- Basem M William
- Department of Medicine, Eastern Maine Medical Center, Bangor, ME, USA
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6
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Johnson EL, Pierpont YN, Donate G, Hiro MH, Mannari RJ, Strickland TJ, Robson MC, Payne WG. Clinical challenge: cutaneous Kaposi's sarcoma of the lower extremity. Int Wound J 2011; 8:163-8. [PMID: 21310005 DOI: 10.1111/j.1742-481x.2010.00763.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Kaposi's sarcoma (KS) typically presents as multiple bilateral cutaneous patches or plaques of the lower extremities. This malignancy, however, can evolve with atypical presentation masquerading as a chronic wound. Lesions can mimic venous stasis ulcers, arterial insufficiency, vascular ulcers or chronic-infected wounds. With acquired immune deficiency syndrome (AIDS)-associated KS, lesions are even more widespread, and can affect the respiratory tract, lymph nodes, gastrointestinal tract, spleen, liver and, rarely, bone. As the initial diagnosis of KS is generally determined clinically, a high index of suspicion is necessary for all patients with a known or suspected history of HIV/AIDS. Tissue biopsy with histological analysis is essential for all wound types in this patient subset, regardless of wound presentation. The purpose of this report is to review the pathogenesis as well as the typical and atypical presentations of KS with an example of a diagnostic dilemma.
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Affiliation(s)
- Erika L Johnson
- Institute for Tissue Regeneration, Repair, & Rehabilitation, Bay Pines V.A. Healthcare System, Bay Pines, FL, USA
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7
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Fasanmade A, Pring M, Pawade J, Guest P, Bell C. Rapidly progressing mass of anterior mandible following a dental extraction. ACTA ACUST UNITED AC 2010; 109:330-4. [PMID: 20219598 DOI: 10.1016/j.tripleo.2009.10.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Revised: 10/02/2009] [Accepted: 10/28/2009] [Indexed: 10/19/2022]
Affiliation(s)
- A Fasanmade
- Department of Oral and Maxillofacial Surgery, United Bristol National Health Service Trust, Foundation Bristol, UK.
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8
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Schwartz RA, Micali G, Nasca MR, Scuderi L. Kaposi sarcoma: a continuing conundrum. J Am Acad Dermatol 2008; 59:179-206; quiz 207-8. [PMID: 18638627 DOI: 10.1016/j.jaad.2008.05.001] [Citation(s) in RCA: 163] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Revised: 04/20/2008] [Accepted: 05/05/2008] [Indexed: 12/11/2022]
Abstract
UNLABELLED Kaposi sarcoma (KS) remains a challenge. Its classic or Mediterranean form tends to be benign. In transplant recipients it may be less so. As part of the AIDS pandemic, of which it was an original defining component, it may be life-threatening. It is due to human herpesvirus-8, which is necessary but not sufficient to produce the disease. KS has a low prevalence in the general population of the United States and United Kingdom, with an intermediate rate in Italy and Greece, and a high one in parts of Africa. In Italy, hot spots include its southern regions, the Po River Valley, and Sardinia, possibly related to a high density of blood-sucking insects. An important challenge is to treat KS patients without immunocompromising them. The potential of effective anti-herpes virus therapy and the use of sirolimus in transplantation recipients have added new opportunities for KS prevention. LEARNING OBJECTIVES At the conclusion of this learning activity, participants should be able to provide the most recent information about Kaposi sarcoma in the context in which it occurs. Its classic or Mediterranean form, its pattern in transplant recipients and others iatrogenically immunosuppressed, and its occurrence as a potentially life-threatening part of the AIDS pandemic will be stressed. Its etiology and transmission will be discussed in detail to facilitate understanding of Kaposi sarcoma and of human herpesvirus-8 infection in the general population of the United States and United Kingdom, in Italy and Greece, and in certain parts of Africa. Its therapy, including the concept of doing it without immunocompromising the patient, will be stressed. New opportunities for Kaposi sarcoma prevention will also be discussed.
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Affiliation(s)
- Robert A Schwartz
- Department of Dermatology, New Jersey Medical School, Newark, New Jersey 07103-2714, USA.
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9
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Levy I, Rolain JM, Lepidi H, Raoult D, Feinmesser M, Lapidoth M, Ben-Amitai D. Is pyogenic granuloma associated with Bartonella infection? J Am Acad Dermatol 2005; 53:1065-6. [PMID: 16310070 DOI: 10.1016/j.jaad.2005.08.046] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2005] [Revised: 08/25/2005] [Accepted: 08/28/2005] [Indexed: 11/19/2022]
Abstract
Lobular capillary hemangioma and bacillary angiomatosis due to Bartonella infection share several clinical and histopathologic characteristics. We sought to determine whether lobular capillary hemangioma is caused by the same agent as bacillary angiomatosis. Forty-five pathology specimens with a histologic diagnosis of lobular capillary hemangioma obtained from patients with the same clinical diagnosis were tested by immunohistochemistry and polymerase chain reaction for the presence of DNA elements of Bartonella spp. None of the 45 lobular capillary hemangioma specimens tested positive for Bartonella spp. We conclude that lobular capillary hemangioma is not associated with Bartonella spp infection. Further research is required to determine the etiologic agent.
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Affiliation(s)
- Itzhak Levy
- Department of Pediatric Infectious Diseases, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.
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10
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Turgut M, Alabaz D, Karakaş M, Kavak M, Aksaray N, Alhan E, Cevlik F, Tuncer I. Bacillary angiomatosis in an immunocompetent child with a grafted traumatic wound. J Dermatol 2005; 31:844-7. [PMID: 15672717 DOI: 10.1111/j.1346-8138.2004.tb00613.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Bacillary angiomatosis is an infectious disease which usually develops in immunocompromised patients. Contact with cats is implicated in its pathogenesis. We report a seven-year-old immunocompetent boy with bacillary angiomatosis without a history of direct contact with cats. The clinical diagnosis of bacillary angiomatosis was made following histopathological examination of a biopsy sample from the infected facial wound, in the vicinity of which angiomatous lesions had developed. Surprisingly, similar lesions also appeared at the donor site of the skin graft which was grafted on the facial wound. This case demonstrates that bacillary angiomatosis may also be seen in immunocompetent patients and that it may contaminate wounds without the intermediary of cats.
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Affiliation(s)
- Mehmet Turgut
- Cukurova University, School of Medicine, Department of Pediatrics Infectious Diseases, Adana, Turkey
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11
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Abstract
While there have been many important advances in the study of Kaposi's sarcoma (KS), it remains both a challenge and an enigma in many ways. Kaposi's original description of "multiple idiopathic hemorrhagic sarcoma[s]" in patients who died within 2-3 years resembles KS in AIDS more than classic KS in elderly men of Italian, Jewish, or Mediterranean lineage, in whom the disease is usually benign. KS had been evident in about one-third of those with early AIDS, often as its presenting sign, a pattern markedly reduced in recent times since the introduction of highly active anti-retroviral therapy (HAART). The most important advance has been the convincing etiologic linkage of KS with human herpesvirus 8 (HHV-8), which is necessary but not sufficient. It has a low prevalence in the general population of the USA and UK, with an intermediate rate in Italy and Greece, and a high one in Uganda. KS risk may be significantly lower in AIDS patients with a history of anti-herpes therapy. Many aspects of HHV-8, including its transmission pattern and different genospecies, are being scrutinized. The diagnosis of KS may be difficult. One should be aware of KS clinical variants, including telangiectatic, eccymotic, and keloidal KS. One must consider a number of other disorders, including bacillary angiomatosis. HHV-8 DNA sequences in dermatofibromas and other tumors should probably not be viewed as representing a marker for KS. Therapeutic options vary for KS. Intralesional and low-dose outpatient intravenous vinblastine may be valuable, as immunosuppression with KS is not a good idea if it can be avoided. Anti-herpes virus therapy may have potential for wide use, especially in preventing the development of KS in at risk populations, such as HHV-8 seropositive individuals undergoing transplantation surgery.
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Affiliation(s)
- Robert A Schwartz
- Dermatology, New Jersey Medical School, Newark, New Jersey 07103, USA.
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12
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Karakaş M, Baba M, Homan S, Akman A, Acar MA, Memişoğlu HR, Gümürdülü D. A case of bacillary angiomatosis presenting as leg ulcers. J Eur Acad Dermatol Venereol 2003; 17:65-7. [PMID: 12602974 DOI: 10.1046/j.1468-3083.2003.00513.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report a 32-year-old immunocompetent man who had multiple leg ulcers caused by bacillary angiomatosis without a history of direct contact with cats. Bacillary angiomatosis should be kept in mind in the differential diagnosis of leg ulcers in cases of unknown aetiology.
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Affiliation(s)
- M Karakaş
- Department of Dermatology, Faculty of Medicine, Cukurova University, 01330, Adana, Turkey.
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13
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Kayaselçuk F, Ceken I, Bircan S, Tuncer I. Bacillary angiomatosis of the scalp in a human immunodeficiency virus-negative patient. J Eur Acad Dermatol Venereol 2002; 16:612-4. [PMID: 12482046 DOI: 10.1046/j.1468-3083.2002.00662.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Bacillary angiomatosis (BA) is a recently recognized bacterial infectious disease that is mainly seen in patients with the acquired immunodeficiency syndrome. BA has rarely been reported in immunocompetent individuals. A case of BA of the scalp in an immunocompetent patient, who was human immunodeficiency virus seronegative, is reported. The importance of differential diagnosis of this lesion is emphasized.
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Affiliation(s)
- F Kayaselçuk
- Department of Pathology, University of Baskent, Adana Medical Center, Adana, Turkey.
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14
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Tsai PS, DeAngelis DD, Spencer WH, Seiff SR. Bacillary angiomatosis of the anterior orbit, eyelid, and conjunctiva. Am J Ophthalmol 2002; 134:433-4. [PMID: 12208256 DOI: 10.1016/s0002-9394(02)01530-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report a case of bacillary angiomatosis of the lower eyelid, conjunctiva, and anterior orbit. DESIGN Interventional case report. METHODS A 76-year-old immunocompromised male patient developed a firm vascularized nodule in his left lower eyelid and anterior orbit. RESULTS An excisional biopsy was performed. Histopathologic examination revealed an abnormal vascular proliferation and a mixed inflammatory infiltrate. A Warthin-Starry stain showed numerous bacilli. These findings are characteristic of bacillary angiomatosis. A serologic specimen was positive for antibodies to Bartonella Quintana. CONCLUSION The lower lid and anterior orbit are rare locations for bacillary angiomatosis. Our case brings to attention the increasing importance of Bartonella infection as a causative agent of ophthalmic diseases.
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Affiliation(s)
- Patricia S Tsai
- Department of Ophthalmology, University of California San Francisco, 94131-0344, USA
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15
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Gazineo JL, Trope BM, Maceira JP, May SB, Coelho JM, Lambert JS, Nogueira SA. Bacillary angiomatosis: description of 13 cases reported in five reference centers for AIDS treatment in Rio de Janeiro, Brazil. Rev Inst Med Trop Sao Paulo 2001; 43:1-6. [PMID: 11246275 DOI: 10.1590/s0036-46652001000100001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this case series was to describe the clinical, laboratory and epidemiological characteristics and the presentation of bacillary angiomatosis cases (and/or parenchymal bacillary peliosis) that were identified in five public hospitals of Rio de Janeiro state between 1990 and 1997; these cases were compared with those previously described in the medical literature. Thirteen case-patients were enrolled in the study; the median age was 39 years and all patients were male. All patients were human immunodeficiency virus type 1 (HIV-1) infected and they had previous or concomitant HIV-associated opportunistic infections or malignancies diagnosed at the time bacillary angiomatosis was diagnosed. Median T4 helper lymphocyte counts of patients was 96 cells per mm(3). Cutaneous involvement was the most common clinical manifestation of bacillary angiomatosis in this study. Clinical remission following appropriate treatment was more common in our case series than that reported in the medical literature, while the incidence of relapse was similar. The frequency of bacillary angiomatosis in HIV patients calculated from two of the hospitals included in our study was 1.42 cases per 1000 patients, similar to the frequencies reported in the medical literature. Bacillary angiomatosis is an unusual opportunistic pathogen in our setting.
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Affiliation(s)
- J L Gazineo
- Serviço de Doenças Infecciosas e Parasitárias, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, RJ, Brasil.
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16
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Karakaş M, Baba M, Aksungur VL, Homan S, Memisoğlu HR, Uğuz A. Bacillary angiomatosis on a region of burned skin in a immunocompetent patient. Br J Dermatol 2000; 143:609-11. [PMID: 10971338 DOI: 10.1111/j.1365-2133.2000.03719.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Bacillary angiomatosis usually develops in immunodeficient patients with a history of contact with cats. We report a 21-year-old immunocompetent woman with facial angiomatous lesions following a second-degree burn and without a history of direct contact with cats. The diagnosis of bacillary angiomatosis was based on the demonstration of bacilli in histological sections stained by the Warthin-Starry method. The lesions resolved 2 months after treatment with oral erythromycin for 8 weeks. This case emphasizes that bacillary angiomatosis may be seen in immunocompetent individuals and may be transmitted in other ways than cat scratches, e.g. by arthropods.
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Affiliation(s)
- M Karakaş
- Departments of Dermatology and Pathology, Faculty of Medicine, Cukurova University, 01330 Adana, Turkey.
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17
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Karem KL, Paddock CD, Regnery RL. Bartonella henselae, B. quintana, and B. bacilliformis: historical pathogens of emerging significance. Microbes Infect 2000; 2:1193-205. [PMID: 11008109 DOI: 10.1016/s1286-4579(00)01273-9] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Bartonella species were virtually unrecognized as modern pathogens of humans until the last decade. However, identification of Bartonella species as the agents of cat-scratch disease, bacillary angiomatosis, urban trench fever, and possible novel presentations of Carrion's disease has left little doubt of the emerging medical importance of this genus of organisms. The three primary human pathogenic bartonellae, Bartonella bacilliformis (Carrion's disease), B. henselae (cat-scratch disease), and B. quintana (trench fever), present noteworthy comparisons in the epidemiology, natural history, pathology, and host-microbe interaction that this review will briefly explore.
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Affiliation(s)
- K L Karem
- Viral and Rickettsial Zoonoses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, US Department of Health and Human Services, Atlanta, Georgia 30333, USA
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