Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.
Bacillary angiomatosis: microbiology, histopathology, clinical presentation, diagnosis and management.
Bol Asoc Med P R. 1995 Jul-Sep;87(7-9):140-6. Unique Identifier : AIDSLINE MED/96292823 Ramirez Ramirez CR; Saavedra S; Ramirez Ronda C; Infectious Diseases Program, University of Puerto Rico School of; Medicine, San Juan 00927-5800.
Abstract:
Bacillary angiomatosis is known to be caused by a rickettsial organism; Rochalimaea henselae. This causative agent has been compared with different microorganisms and clinical conditions that appear in similar settings buy have been clearly differentiated from them; e.i. Cat-scratch disease (Afipia felis), Bartonella bacilliformis, other Rochalimaea sp., Kaposi's sarcoma, Lobular capillary hemangioma, Angiosarcoma, and Epithelioid hemangioma. Clinically the bacillary angiomatosis (BA) skin lesions vary from a single lesion to thousands. The cutaneous lesion appears as a bright-red round papule, subcutaneous nodule, or as a cellulitic plaque. When the lesion is biopsied it tends to blanch-out, bleed, and cause pain. The patient might present with signs and symptoms of chills, headaches, fever, malaise, and anorexia with or without weight loss. The extracutaneous lesions found in BA tend to be from multiple organs affecting from the oral lesions to anal mucosal lesions to widespread visceral lesions. The sites of preference for BA lesion manifestation tend to be the liver, spleen, lymph nodes, and bone. To diagnose bacillary angiomatosis the physician should prepare a differential diagnosis based primarily on its histopathological and clinical characteristics. To confirm the results from the stain, electron microscopy can identify the bacillus and pin-point the diagnosis of bacillary angiomatosis. The lesions presented by BA respond well to therapy with erythromycin 500 mg four times daily for a duration of 2 weeks to 2 months. In case of intolerance to erythromycin the second line of drug that successfully treats the BA bacillus is doxycyline. If relapses of the BA lesion recur, then a prolonged antibiotic therapy is necessary and in AIDS patients the duration may be extended as life-long suppressive therapy.
Keywords: *Angiomatosis, Bacillary/DIAGNOSIS/DRUG THERAPY Antibiotics, Macrolide/ADMINISTRATION & DOSAGE/THERAPEUTIC USE Antibiotics, Tetracycline/ADMINISTRATION & DOSAGE/THERAPEUTIC USE Comparative Study Diagnosis, Differential Doxycycline/ADMINISTRATION & DOSAGE/THERAPEUTIC USE Erythromycin/ADMINISTRATION & DOSAGE/THERAPEUTIC USE Human Sarcoma, Kaposi's/DIAGNOSIS Time Factors JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL
961130
M96B1675
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Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.
