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Home :: Bacillary Angiomatosis

Bacillary Angiomatosis

Bacillary angiomatosis (BA) is a systemic infection caused by Bartonella species, occurring nearly exclusively in HIV-infected individuals, characterized by cutaneous vascular tumors resembling Kaposi's sarcoma and symptomatic multisystemic infection, most commonly involving the liver (peliosis hepatis) and/or spleen (parenchymal bacillary peliosis).

Causes of Bacillary Angiomatosis

Bartonella spp. cause vascular proliferation (angiogenesis): B.bacilliformis, verruga peruana; B.henselae and B.quintana, BA.

Additional risk factors for bacillary angiomatosis associated with B quintana infection include the following:

  • Homelessness
  • Low socioeconomic status
  • Exposure to body and hair lice

Risk factors for bacillary angiomatosis include the following:

  • HIV infection
  • Chronic lymphocytic leukemia
  • Cytotoxic chemotherapy
  • Organ transplantations

Symptoms of Bacillary Angiomatosis

  • high fever
  • tender and swollen lymph nodes
  • nausea
  • vomiting
  • sweats
  • chills
  • poor appetite
  • Weight loss
  • Gastrointestinal symptoms

Diagnosis

Clinical findings confirmed by demonstration of Bartonella bacilli on silver stain of lesional biopsy specimen or culture or antibody studies.

Treatment

Antimicrobial Therapy Given for 8 to 12 weeks. A Jarisch-Herxheimer type reaction may occur shortly after beginning therapy.

  • Erythromycin 500 mg PO qid or
  • Doxycycline 100 mg PO bid or
  • Ciprofloxacin 750 mg PO bid or
  • Azithromycin 500 mg PO qd

SecondaryProphylaxis Lifelong maintenance if relapses occur.

Prevention

HIV-infected individuals should avoid contact with cats, especially kittens, to minimize the risk for acquiring BA, as well as toxoplasmosis.

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