Bacillary angiomatosis
Bacillary angiomatosis
Bacillary angiomatosis is an infection caused by two species of Bartonella - B. henselae and B. quintana. These bacteria are extremely difficult to culture. One of the agents causing bacillary angiomatosis, B. henselae, is associated with cat scratch disease. Cat exposure and cat scratches are risk factors for acquiring bacillary angiomatosis.
Visceral disease may include osseous lesions, hepatic and splenic involvement, lymph node disease, pulmonary lesions, brain lesions, and widespread fatal systemic involvement.
Clinical Features
Bacillary angiomatosis is characterized by pyogenic granulomas — fleshy, friable, protuberant papules-to-nodules that tend to bleed very easily. In addition, deep cellulitic plaques and subcutaneous nodules may occur. Lesions number from a few to hundreds. Diagnosis is confirmed by biopsy.
Fever, night sweats, weight loss, and anemia are common. Involvement of the liver and spleen is the most commonly diagnosed form of visceral disease. These patients present with abdominal pain, fevers, elevated levels on liver function tests, and hepatosplenomegaly.
Treatment. Erythromycin (500 mg orally 4 times daily) or doxycycline (100 mg orally twice daily) is effective. Therapy should continue for 8 weeks. Patients with visceral disease should receive 4 months of therapy.