Bacillary angiomatosis
From IDWiki
Revision as of 00:49, 17 September 2020 by Aidan (talk | contribs) (Created page with "== Background == * Caused by Bartonella henselae and Bartonella quintana * Classically occurs in patients with advanced HIV == Clinical Manifestations == * Diss...")
Background
- Caused by Bartonella henselae and Bartonella quintana
- Classically occurs in patients with advanced HIV
Clinical Manifestations
- Disseminated skin infection
- Characterized by protuberant, reddish-purple, berry-like nodules
- Often surrounding dry scale
- Can bleed profusely
- More common on upper extremities
- May arise in crops of papules and nodules
- Can affect essentially all internal organs as well
- Subcutaneous lesions are more common with Bartonella quintana
- Hepatic and splenic peliosis are more common with Bartonella henselae
- Neovascular proliferation
Differential Diagnosis
- Essentially indistinguishable from Kaposi sarcoma in patients with HIV
- Pyogenic granuloma is the most notable differential diagnosis in immunocompetent hosts
Diagnosis
- Histopathology, culture, and PCR of skin lesions
- Notify lab, as may need prolonged incubation time
Management
- Treated by erythromycin 500 mg PO q6h or doxycycline 100 mg PO q12h for 3 or more months
- Should start to respond within 3 to 4 weeks
- Alternatives include fluoroquinolones or azithromycin
- Treatment of the underlying immunodeficiency, if applicable
