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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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Rotundo S, Bono F, Mazzitelli M, Scaglione V, Lamberti AG, Giancotti A, Tucci L, Costa C, Tassone MT, Morrone HL, Trecarichi EM, Torti C. An autochthonous case of cutaneous bacillary angiomatosis not related to major immunosuppression: An emerging or overlooked disease? Int J Infect Dis 2024; 138:21-24. [PMID: 37967716 DOI: 10.1016/j.ijid.2023.11.016] [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: 07/04/2023] [Revised: 10/19/2023] [Accepted: 11/11/2023] [Indexed: 11/17/2023] Open
Abstract
Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella henselae or Bartonella quintana that has been mostly described in people living with HIV. Since cBA is considered to be rare in hosts not affected by major immunosuppression, it could be underdiagnosed in this population. Moreover, antimicrobial treatment of cBA has been poorly validated, thus reporting experiences on this clinical entity is important. We reported a challenging and well-characterized case of an Italian 67-year-old gentleman without a history of major immunocompromizing conditions, although he was affected by conditions that can be associated with impaired immune function. The patient reported herein was diagnosed after a long time since the initiation of symptoms and was successfully treated with combined antibiotic therapy including macrolides and quinolones under the guidance of molecular test results. Physicians should consider cBA as a possible manifestation of Bartonella spp. Infection in patients not suffering from major immunocompromizing 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
- Infectious and Tropical Diseases Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Francesco Bono
- Neurological Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Maria Mazzitelli
- Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy.
| | - Vincenzo Scaglione
- Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy.
| | | | - Aida Giancotti
- Microbiology Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Luigi Tucci
- Pathology Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Chiara Costa
- Infectious and Tropical Diseases Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Maria Teresa Tassone
- Infectious and Tropical Diseases Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Helen Linda Morrone
- Infectious and Tropical Diseases Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Enrico Maria Trecarichi
- Infectious and Tropical Diseases Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Carlo Torti
- Infectious and Tropical Diseases Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
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A RK, K N, Krishnan RK, Dinesh S, R R. Bacillary Angiomatosis Mimicking Pyogenic Granuloma. Cureus 2023; 15:e36844. [PMID: 37123686 PMCID: PMC10147494 DOI: 10.7759/cureus.36844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 03/30/2023] Open
Abstract
Bacillary angiomatosis (BA) is an angioproliferative disease caused by Bartonella species. It manifests as nodules or papules in immunocompromised patients. Oral lesions are very rare, unlike cutaneous lesions, and histopathology plays a vital role in distinguishing these lesions from other similar ones. Treatment mainly comprises macrolides erythromycin, clarithromycin, or doxycycline.
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4
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Atherton K, Hinen H. Vascular Anomalies. Dermatol Clin 2022; 40:401-423. [DOI: 10.1016/j.det.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Singal A, Agrawal S, Arora V. Bacillary angiomatosis in an immunocompetent patient: An unusual occurrence. Indian Dermatol Online J 2022; 13:527-529. [PMID: 36262580 PMCID: PMC9574148 DOI: 10.4103/idoj.idoj_524_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 08/27/2021] [Accepted: 09/27/2021] [Indexed: 11/20/2022] Open
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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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Lins KDA, Drummond MR, Velho PENF. Cutaneous manifestations of bartonellosis. An Bras Dermatol 2019; 94:594-602. [PMID: 31780437 PMCID: PMC6857551 DOI: 10.1016/j.abd.2019.09.024] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 02/27/2019] [Indexed: 12/20/2022] Open
Abstract
Bartonellosis are diseases caused by any kind of Bartonella species. The infection manifests as asymptomatic bacteremia to potentially fatal disorders. Many species are pathogenic to humans, but three are responsible for most clinical symptoms: Bartonella bacilliformis, Bartonella quintana, and Bartonella henselae. Peruvian wart, caused by B. bacilliformis, may be indistinguishable from bacillary angiomatosis caused by the other two species. Other cutaneous manifestations include maculo-papular rash in trench fever, papules or nodules in cat scratch disease, and vasculitis (often associated with endocarditis). In addition, febrile morbilliform rash, purpura, urticaria, erythema nodosum, erythema multiforme, erythema marginatus, granuloma annularis, leukocytoclastic vasculitis, granulomatous reactions, and angioproliferative reactions may occur. Considering the broad spectrum of infection and the potential complications associated with Bartonella spp., the infection should be considered by physicians more frequently among the differential diagnoses of idiopathic conditions. Health professionals and researchers often neglected this diseases.
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Affiliation(s)
- Karina de Almeida Lins
- Department of Clinical Medicine, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil; Laboratory of Applied Research in Dermatology and Bartonella Infection, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Marina Rovani Drummond
- Department of Clinical Medicine, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil; Laboratory of Applied Research in Dermatology and Bartonella Infection, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Paulo Eduardo Neves Ferreira Velho
- Laboratory of Applied Research in Dermatology and Bartonella Infection, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil; Discipline of Dermatology, Department of Clinical Medicine, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil.
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Abstract
This overview of mesenchymal tumors presenting in the skin and/or subcutis in children brings together the range of neoplasms and hamartomas which are seen in this age-group. It is not surprising from the perspective of the pediatric or general surgical pathologist that vascular anomalies, including true neoplasms and vascular malformations, are the common phenotypic category. Since there is considerable morphologic overlap among these lesions, clinicopathologic correlation may be more important than for many of the other mesenchymal tumors. The skin and subcutis are the most common sites of clinical presentation for the infantile myofibroma which is the most common of fibrous mesenchymal tumors in children. Several of the other mesenchymal tumors are more common adults-like dermatofibrosarcoma protuberans, but nonetheless have an important presence in children, even as a congenital neoplasm. A lipomatous tumor in a young child should be considered as a possible manifestation of an overgrowth syndrome.
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Affiliation(s)
- Louis P Dehner
- 1 Lauren V. Ackerman Laboratory of Surgical Pathology, St. Louis Children's Hospital, Washington University Medical Center, St. Louis, Missouri.,2 Dermatopathology Center and Division of Dermatology, Washington University Medical Center, St. Louis, Missouri
| | - Alejandro A Gru
- 3 Department of Pathology, University of Virginia, Charlottesville, Virginia.,4 Department of Dermatology, University of Virginia, Charlottesville, Virginia
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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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Zangwill KM. Cat Scratch Disease and Other Bartonella Infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013; 764:159-66. [DOI: 10.1007/978-1-4614-4726-9_13] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Grumbkow PV, Zipp A, Seidenberg V, Fehren-Schmitz L, Kempf VAJ, Gross U, Hummel S. Brief communication: Evidence of Bartonella quintana infections in skeletons of a historical mass grave in Kassel, Germany. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2011; 146:134-7. [PMID: 21710687 DOI: 10.1002/ajpa.21551] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Philipp V Grumbkow
- Institute of Zoology and Anthropology, Department of Historical Anthropology and Human Ecology, Georg-August-University Goettingen, Buergerstraße 50, 37073 Goettingen, Germany.
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