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Experimental and Therapeutic Medicine Jul 2020Bacillary angiomatosis represents a cutaneous and systemic infection caused by species, typically described in the past in HIV-positive patients or associated with...
Bacillary angiomatosis represents a cutaneous and systemic infection caused by 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.
PubMed: 32508994
DOI: 10.3892/etm.2019.8260 -
Annales de Biologie Clinique 1998The recent discovery of the bacterium Bartonella henselae was mainly due to the development of molecular biology techniques adapted to microbial diagnosis and to the... (Review)
Review
The recent discovery of the bacterium Bartonella henselae was mainly due to the development of molecular biology techniques adapted to microbial diagnosis and to the description of new human diseases linked to Aids. About 10% of pet cats and 33% of stray cats harbour that bacterium in their blood. In immunocompetent patients, that bacterium is responsible for human cat scratch disease, characterized essentially by a localized lymph nodes enlargement in the vicinity of the entry site of the bacteria. This disease occurs more likely in pet cats less than 1-year-old and infested with fleas. The bacterium is transmitted to humans by scratches or bites; the role of fleas is possible, but is not yet documented. In 5 to 13% of cases, the cat scratch disease appears as more severe, including health impairment, hepatitis, Parinaud's oculo-glandular syndrome, neurological complications or stellate retinitis. In immunocompromised patients, B. henselae is responsible for various clinical presentations: bacillary angiomatosis, bacillary peliosis, recurrent or persistent bacteremia or endocarditis. Diagnosis of infections due to B. henselae can be performed by serological specific testing with sensitivity and specificity values ranging from 75 to 100%. Cultivation of the bacterium is fastidious, particularly in cases of cat scratch disease. The most efficient diagnostic test is the in vitro DNA amplification which has the drawback to require a lymph node sample. Antibiotics are usually inefficient for the treatment of cat scratch disease. By contrast, in immunocompromised patients, these infections are successfully treated for a more or less long time by macrolides or tetracyclines or rifampin.
Topics: Animals; Bartonella henselae; Cat-Scratch Disease; Cats; Humans; Sensitivity and Specificity
PubMed: 9853027
DOI: No ID Found -
Case Reports in Infectious Diseases 2013We present a 63-year-old man treated with alemtuzumab for chronic lymphocytic leukemia who developed multiple angiomatous papules and fever. Real-time polymerase chain...
We present a 63-year-old man treated with alemtuzumab for chronic lymphocytic leukemia who developed multiple angiomatous papules and fever. Real-time polymerase chain reaction (RT-PCR) from a skin lesion and blood sample revealed Bartonella quintana as causative agent confirming the diagnosis of bacillary angiomatosis with bacteremia. Treatment with doxycycline, initially in combination with gentamicin, led to complete resolution of the lesions. This case shows the importance of considering bacillary angiomatosis as a rare differential diagnosis of angiomatous lesions in the immunocompromised patient, particularly in chronic lymphocytic leukemia and following lymphocyte depleting treatments as alemtuzumab.
PubMed: 23710386
DOI: 10.1155/2013/694765 -
The Western Journal of Medicine Feb 1992
Topics: Angiomatosis, Bacillary; Humans
PubMed: 1536075
DOI: No ID Found -
Clinical Microbiology Reviews Apr 1997Members of the genus Bartonella (formerly Rochalimaea) were virtually unknown to modern-day clinicians and microbiologists until they were associated with opportunistic... (Review)
Review
Members of the genus Bartonella (formerly Rochalimaea) were virtually unknown to modern-day clinicians and microbiologists until they were associated with opportunistic infections in AIDS patients about 6 years ago. Since that time, Bartonella species have been associated with cat scratch disease, bacillary angiomatosis, and a variety of other disease syndromes. Clinical presentation of infection with Bartonella ranges from a relatively mild lymphadenopathy with few other symptoms, seen in cat scratch disease, to life-threatening systemic disease in the immunocompromised patient. In some individuals, infection manifests as lesions that exhibit proliferation of endothelial cells and neovascularization, a pathogenic process unique to this genus of bacteria. As the spectrum of disease attributed to Bartonella is further defined, the need for reliable laboratory methods to diagnose infections caused by these unique organisms also increases. A brief summary of the clinical presentations associated with Bartonella infections is presented, and the current status of laboratory diagnosis and identification of these organisms is reviewed.
Topics: Animals; Bartonella; Bartonella Infections; Cat-Scratch Disease; Cats; Humans; Immunocompromised Host; Molecular Biology; Polymerase Chain Reaction
PubMed: 9105751
DOI: 10.1128/CMR.10.2.203 -
Pathogens (Basel, Switzerland) Mar 2021, , and are bacteria known to cause verruga peruana or bacillary angiomatosis, vascular endothelial growth factor (VEGF)-dependent cutaneous lesions in humans. Given...
, , and are bacteria known to cause verruga peruana or bacillary angiomatosis, vascular endothelial growth factor (VEGF)-dependent cutaneous lesions in humans. Given the bacteria's association with the dermal niche and clinical suspicion of occult infection by a dermatologist, we determined if patients with melanoma had evidence of spp. infection. Within a one-month period, eight patients previously diagnosed with melanoma volunteered to be tested for evidence of spp. exposure/infection. Subsequently, confocal immunohistochemistry and PCR for spp. were used to study melanoma tissues from two patients. Blood from seven of the eight patients was either seroreactive, PCR positive, or positive by both modalities for spp. exposure. Subsequently, organisms that co-localized with VEGFC immunoreactivity were visualized using multi-immunostaining confocal microscopy of thick skin sections from two patients. Using a co-culture model, was observed to enter melanoma cell cytoplasm and resulted in increased vascular endothelial growth factor C (VEGFC) and interleukin 8 (IL-8) production. Findings from this small number of patients support the need for future investigations to determine the extent to which spp. are a component of the melanoma pathobiome.
PubMed: 33802018
DOI: 10.3390/pathogens10030326 -
Indian Journal of Dermatology 2022
PubMed: 36998856
DOI: 10.4103/ijd.ijd_819_22 -
Medicine Jul 2016The clinical manifestation of bacillary angiomatosis (BA) can be limited to one organ, most commonly the skin, but systemic courses can also occur. We report a human...
BACKGROUND
The clinical manifestation of bacillary angiomatosis (BA) can be limited to one organ, most commonly the skin, but systemic courses can also occur. We report a human immunodeficiency virus (HIV)-positive patient with a systemic manifestation of BA caused by Bartonella quintana, diagnosed in Vienna, Austria. The pathogen was detected in multiple organs including a facial tumor which is an unusual finding for BA. Furthermore, infections with B quintana are rare in our area and no other autochthonous cases have been reported.
METHODS AND RESULTS
The clinical manifestation included multiple papules and nodules on the entire body, several organic abscesses, and a facial tumor influencing the patient's view.The main laboratory finding indicated HIV infection combined with severe immunosuppression with 47 CD4 cells/μL. Contrast-enhanced computed tomography of the chest and the abdomen showed multiple and abscesses. Histological examination of the facial tumor confirmed inflammatory process. Bartonella quintana was detected by PCR in blood and in the facial tumor as well as by culture in the skin tissue. Antibiotic treatment with doxycycline and antiretroviral therapy resulted in clinical improvement.
CONCLUSION
Our case shows that rare opportunistic, vector-borne infections, usually associated with poverty, can lead to diagnosis of HIV even in well-developed countries. Furthermore, we provide details on clinical manifestation and diagnostic work-up which might expand the knowledge on disseminated infections with B quintana. As far, tumorous deformations have rarely been reported as consequence of BA. In our patient the pathogen was detected in the facial tumor using PCR techniques.
Topics: AIDS-Related Opportunistic Infections; Abscess; Adult; Angiomatosis, Bacillary; Austria; Bartonella quintana; Contrast Media; Face; HIV Infections; Humans; Immunocompromised Host; Male; Polymerase Chain Reaction; Tomography, X-Ray Computed
PubMed: 27428207
DOI: 10.1097/MD.0000000000004155 -
Skinmed 2021A 37-year-old man with a history of renal transplantation in 2013 due to focal segmental glomerulosclerosis presented to the emergency room with a 2-week history of...
A 37-year-old man with a history of renal transplantation in 2013 due to focal segmental glomerulosclerosis presented to the emergency room with a 2-week history of fever, chills, anorexia, weight loss, abdominal pain, diarrhea, and a new asymptomatic lesion on the right side of the neck. The patient worked as a truck driver and frequently traveled to Wisconsin; he had not traveled internationally in the past year. He lived with his brother who had a pet cat. He was compliant with his anti-rejection medication regimen, which included mycophenolate mofetil, tacrolimus, and prednisone. Physical examination of the neck revealed an 8-mm exophytic, friable, red papule with overlying blood crusts (Figure 1). The remainder of the mucocutaneous examination was unremarkable, and there was no palpable lymphadenopathy. The patient was started on empiric intravenous cefepime and metronidazole and admitted to the hospital for further management. A punch biopsy of the lesion was performed.
Topics: Adult; Angiomatosis, Bacillary; Anti-Bacterial Agents; Humans; Kidney Transplantation; Male; Neck; Prednisone
PubMed: 33938441
DOI: No ID Found -
The Lancet. Infectious Diseases Oct 2022Bacillary peliosis hepatis is a well recognised manifestation of disseminated Bartonella henselae infection that can occur in immunocompromised individuals.... (Review)
Review
Bacillary peliosis hepatis is a well recognised manifestation of disseminated Bartonella henselae infection that can occur in immunocompromised individuals. Haemophagocytic lymphohistiocytosis is an immune-mediated condition with features that can overlap with a severe primary infection such as disseminated Bartonella spp infection. We report a case of bacillary peliosis hepatis and secondary haemophagocytic lymphohistiocytosis due to disseminated Bartonella spp infection in a kidney-transplant recipient with well controlled HIV. The patient reported 2 weeks of fever and abdominal pain and was found to have hepatomegaly. He recalled exposure to a sick dog but reported no cat exposures. Laboratory evaluation was notable for pancytopenia and cholestatic injury. The patient met more than five of eight clinical criteria for haemophagocytic lymphohistiocytosis. Pathology review of a bone marrow core biopsy identified haemophagocytosis. A transjugular liver biopsy was done, and histopathology review identified peliosis hepatis. Warthin-Starry staining of the bone marrow showed pleiomorphic coccobacillary organisms. The B henselae IgG titre was 1:512, and Bartonella-specific DNA targets were detected by peripheral blood PCR. Treatment with doxycycline, increased prednisone, and pausing the mycophenolate component of his transplant immunosuppression regimen resulted in an excellent clinical response. Secondary haemophagocytic lymphohistiocytosis can be difficult to distinguish from severe systemic infection. A high index of suspicion can support the diagnosis of systemic Bartonella spp infection in those who present with haemophagocytic lymphohistiocytosis, especially in patients with hepatomegaly, immunosuppression, and germane animal exposures.
Topics: Angiomatosis, Bacillary; Animals; Bartonella; Bartonella Infections; Bartonella henselae; Dogs; Doxycycline; HIV Infections; Hepatomegaly; Immunoglobulin G; Kidney Transplantation; Lymphohistiocytosis, Hemophagocytic; Male; Peliosis Hepatis; Prednisone
PubMed: 35500593
DOI: 10.1016/S1473-3099(22)00276-6