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bacillary angiomatosis
Etiology:
1) Bartonella henselae
2) Bartonella quintana
3) Epstein-Barr virus in AIDS (some cases)
Pathology:
1) angioproliferative vascular lesions
2) nodules involving the skin, bone, liver, spleen & lymph nodes
Microscopic Pathology:
- resembles pyogenic granuloma and lobular capillary hemangioma
Immunohistochemistry:
1) factor VIII: +
2) Ulex lectin: +
Clinical manifestations:
1) cutaneous manifestations
a) friable, vascular papules
b) cellulitic plaques
2) systemic manifestations
a) high fever/chills
b) sweats
c) anorexia
d) weight loss
e) abdominal symptoms
Laboratory:
1) skin biopsies
- Warthin-Starry silver stain
2) blood cultures with prolonged incubation & serial subcultures
3) serology
Differential diagnosis:
1) Kaposi's sarcoma
2) non-tuberculous mycobacterial infection
Management:
1) erythromycin
2) erythromycin plus rifampin
3) erythromycin plus gentamicin
4) ceftriaxone plus gentamicin
5) doxycycline plus gentamicin
6) clarithromycin
7) treatment for 4 weeks
8) Jarisch-Herxheimer reaction may be observed after initiation of therapy
Related
Bartonella henselae (Rochalimaea henselae)
Bartonella quintana (Rochalimaea quintana)
General
bacterial infection
References
Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998