bacillary angiomatosis

Etiology

• Bartonella henselae
• Bartonella quintana
• Epstein-Barr virus in AIDS (some cases)

Pathology

• angioproliferative vascular lesions
• nodules involving the skin, bone, liver, spleen & lymph nodes

Microscopic pathology

• resembles pyogenic granuloma and lobular capillary hemangioma

Immunophenotype

• factor VIII: +
• Ulex lectin: +

Clinical manifestations

• cutaneous manifestations
  • friable, vascular papules
  • cellulitic plaques
• systemic manifestations
  • high fever/chills
  • sweats
  • anorexia
  • weight loss
  • abdominal symptoms

Laboratory

• skin biopsies
  • Warthin-Starry silver stain
• blood cultures with prolonged incubation & serial subcultures
• serology

Differential diagnosis

• Kaposi's sarcoma
• non-tuberculous mycobacterial infection

Management

• erythromycin
• erythromycin plus rifampin
• erythromycin plus gentamicin
• ceftriaxone plus gentamicin
• doxycycline plus gentamicin
• clarithromycin
• treatment for 4 weeks
• Jarisch-Herxheimer reaction may be observed after initiation of therapy

More general terms

• bacterial infection

Additional terms

• Bartonella henselae (Rochalimaea henselae)
• Bartonella quintana (Rochalimaea quintana)