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International Journal of Microbiology 2023Dermatological disorders are among the most prevalent manifestations of HIV infection/acquired immunodeficiency syndrome (AIDS). In this review, we aimed to characterize... (Review)
Review
Dermatological disorders are among the most prevalent manifestations of HIV infection/acquired immunodeficiency syndrome (AIDS). In this review, we aimed to characterize the various dermatologic presentations among HIV-infected patients with a detailed categorization of the mucocutaneous signs and symptoms, their etiopathogenic factors, and clinical management. In fact, cutaneous manifestations of HIV are quite various, ranging from AIDS-specific skin eruptions (xerosis, pruritic papular eruptions, eosinophilic folliculitis, and acne), opportunistic infections (herpes simplex, molluscum contagiosum, cutaneous leishmaniasis, bacillary angiomatosis, disseminated histoplasmosis, disseminated cryptococcosis, and zoster) to AIDS-related malignancies (Kaposi's sarcoma, lymphoma, and nonmelanoma skin cancers) and antiretroviral therapy (ART)-associated drug eruptions. We tried to classify HIV-related cutaneous presentations which can help clinicians for a better understanding of the various specific and nonspecific features of AIDS-associated cutaneous manifestations and management of the condition.
PubMed: 37496761
DOI: 10.1155/2023/6203193 -
International Journal of Infectious... Aug 2023Bacillary angiomatosis is a disseminated vascular proliferative disease caused by aerobic gram-negative bacilli Bartonella henselae or Bartonella quintana. Bacillary...
Bacillary angiomatosis is a disseminated vascular proliferative disease caused by aerobic gram-negative bacilli Bartonella henselae or Bartonella quintana. Bacillary angiomatosis is mostly described in immunosuppressed patients with HIV infection and organ transplant recipients. We describe the case of a female aged 75 years who is a kidney transplant recipient who was admitted for a 3-month history of intermittent fever, chills, vomiting, and a 12-kg weight loss. The maintenance immunosuppression was based on prednisone, mycophenolate, and monthly infusions of belatacept. Physical examination was unremarkable. Laboratory investigations revealed elevated blood acute phase proteins but all blood cultures were negative. Serological tests for Bartonella were negative. Thoracoabdominal computed tomography scan and transesophageal echocardiography were normal. A Positron Emission Tomography scan showed a hypermetabolic mass in the duodenopancreatic region, with multiple hepatic and splenic lesions. Histological findings of spleen and pancreatic biopsies were not conclusive. The histopathological examination of a celiac lymph node biopsy finally demonstrated bacillary angiomatosis. The diagnosis of bacillary angiomatosis in immunocompromised patients is most often delayed in the absence of skin involvement. A high index of clinical suspicion is needed when interpreting negative results.
Topics: Humans; Female; Angiomatosis, Bacillary; Abatacept; HIV Infections; Kidney Transplantation; Immunosuppression Therapy
PubMed: 37086865
DOI: 10.1016/j.ijid.2023.04.404 -
Leukemia Research Reports 2024Bartonelloses are diseases caused by Bartonella sp., transmitted to humans by blood sucking arthropod vectors. Clinical presentations include bacillary angiomatosis, cat... (Review)
Review
Bartonelloses are diseases caused by Bartonella sp., transmitted to humans by blood sucking arthropod vectors. Clinical presentations include bacillary angiomatosis, cat scratch disease and atypical forms. We performed a review of cases of bartonelloses and hematological malignancies published in HIV-negative patients. Terms used were Bartonella or Bacillary Angiomatosis and Leukemia, Lymphoma, Multiple Myeloma, or Cancer. Fifteen cases met our criteria. Clinical presentations included bacillary angiomatosis, chronic fever, chronic lymphadenopathy, osteomyelitis, neuroretinitis, chronic anemia and hepatosplenic peliosis. Fourteen patients were asymptomatic after antibiotic therapy, and one died before antibiotic treatment. Clinicians should be suspicious of Bartonella sp. infections in immunocompromised patients.
PubMed: 38192503
DOI: 10.1016/j.lrr.2023.100402 -
BMC Infectious Diseases Apr 2024Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella spp. that mostly affects people living with HIV (PLWH), transplanted...
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.
Topics: Humans; Angiomatosis, Bacillary; Skin; Anti-Bacterial Agents; Immunocompromised Host
PubMed: 38589795
DOI: 10.1186/s12879-024-09253-9 -
Cureus Aug 2023Cat scratch disease (CSD) is caused by a bacterial infection due to and is associated with young cats and kittens. CSD commonly occurs as regional lymphadenitis in the...
Cat scratch disease (CSD) is caused by a bacterial infection due to and is associated with young cats and kittens. CSD commonly occurs as regional lymphadenitis in the setting of subacute regional lymphadenopathy predominantly in children and young adults. The prognosis for immunocompetent patients is favorable with complete recovery, however, immunocompromised adults can progress to life-threatening complications such as neuroretinitis, osteomyelitis, and bacillary angiomatosis. is transmitted from cats to humans through scratching or biting when located on the cat's claws or oral cavity. In 1% of diagnosed cases, patients developed this disease without ever receiving an animal scratch. We present a case of a 29-year-old immunocompetent male developing severe right inguinal pain with concern for an incarcerated inguinal hernia. He reported exposure to a vaccinated six-month-old kitten but denied any recent scratches or bites. His infectious workup revealed right inguinal lymphadenitis on CT imaging and subsequent lymph node biopsy confirmed a diagnosis of CSD. He was treated with a short course of oral doxycycline for CSD and opioids for pain management. This case illustrates the importance of thorough complete history and physical taking even in immunocompetent patients and early recognition with prompt targeted treatment of lymphadenitis to prevent unfavorable outcomes.
PubMed: 37772236
DOI: 10.7759/cureus.44280 -
International Journal of Infectious... Jan 2024Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella henselae or Bartonella quintana that has been mostly described in people...
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.
Topics: Male; Humans; Aged; Angiomatosis, Bacillary; Bartonella quintana; Skin; Anti-Bacterial Agents; Immunosuppression Therapy; Bartonella henselae
PubMed: 37967716
DOI: 10.1016/j.ijid.2023.11.016