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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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Brzewski P, Kwiecińska M, Sułowicz J, Podolec K, Obtułowicz A, Dyduch G, Wojas-Pelc A. Bacillary Angiomatosis in Renal Transplant Recipient: A Case Report. Transplant Proc 2020; 52:2524-2526. [PMID: 32334794 DOI: 10.1016/j.transproceed.2020.02.092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 02/05/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Bacillary angiomatosis (BA) is a rare, opportunistic infectious disease caused by the aerobic Gram-negative bacilli Bartonella henselae or Bartonella quintana. The main reservoir for those microbes are cats. The disease mostly affects immunocompromised patients with human immunodeficiency virus infection, after organ transplantation, undergoing corticosteroid and methotrexate therapy or with oncological history. CASE REPORT We represent the case of a 65-year-old man who reported to the Department of Dermatology with a high fever and numerous nodular skin lesions on the 5th month of kidney transplantation. At that time, his immunosuppressive therapy consisted of tacrolimus 6 mg/day, mycophenolate mofetil 2 g/day, and prednisone 5 mg/day. Laboratory tests revealed an increased leukocyte count and elevated values of acute-phase proteins, but blood cultures were negative. Skin biopsy was performed and BA was diagnosed. The patient was given oral doxycycline 100 mg twice a day. During antibiotic therapy, his body temperature normalized and skin lesions began to resolve. The patient continued the above treatment for the next 3 months with good tolerance, and no relapse occurred in 1 year. CONCLUSION BA should be listed among possible opportunistic infections in organ transplant recipients.
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Affiliation(s)
- Paweł Brzewski
- Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland
| | - Maria Kwiecińska
- Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland
| | - Joanna Sułowicz
- Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland.
| | - Katarzyna Podolec
- Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland
| | | | - Grzegorz Dyduch
- Department of Pathomorphology, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Wojas-Pelc
- Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland
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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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Valenzuela-Oñate C, Magdaleno-Tapial J, Giacaman von der Weth M, Perez-Ferriols A, Sanchez Carazo JL, Ricart-Olmos C, Herrera Cervera M, Forteza Vila J, Alegre de Miquel V. Disseminated skin nodules in a migrant patient. JAAD Case Rep 2019; 5:430-432. [PMID: 31192986 PMCID: PMC6510958 DOI: 10.1016/j.jdcr.2019.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
| | - Jorge Magdaleno-Tapial
- Department of Dermatology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
- Correspondence to: Jorge Magdaleno-Tapial, MD, Avenida Tres Cruces #2, Valencia, Spain 46014.
| | | | - Amparo Perez-Ferriols
- Department of Dermatology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Jose Luis Sanchez Carazo
- Department of Dermatology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Carmen Ricart-Olmos
- Department of Infectious Diseases, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Mario Herrera Cervera
- Instituto Valenciano de Patologia, Centro de Investigación Principe Felipe – Universidad Católica de Valencia, Valencia, Spain
| | - Jeronimo Forteza Vila
- Instituto Valenciano de Patologia, Centro de Investigación Principe Felipe – Universidad Católica de Valencia, Valencia, Spain
| | - Victor Alegre de Miquel
- Department of Dermatology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
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