Bacillary Angiomatosis - Symptoms & Treatment

Bacillary angiomatosis is an infection caused by bacteria from the genus Rochalimaea. Bacillary angiomatosis is characterized histologically by proliferation of small rounded blood vessels lined by plump (epithelioid or histiocytoid) endothelial cells, in an edematous stroma.  Bartonella henselae has been recognized as the causative agent of bacillary angiomatosis in HIV-infected patients. The infection is rarely seen today in patients who don't have HIV. Bartonella occurs far more frequently in North and South America than in Europe. Bacillary angiomatosis may affect almost any organ system, although it most commonly affects skin and subcutaneous tissue. Subcutaneous lesions may erode into underlying bones (ie, osseous bacillary angiomatosis), especially the tibia, fibula, and radius. Involvement of ribs and vertebrae has been described. It most commonly manifests in people with AIDS, rarely appearing in those who are immunocompetent. In normal people the disease is self-limited and usually goes away by itself in a few weeks.

Bacillary angiomatosis has been suggested to be caused with equal frequency by B henselae and B quintana. In each pair of figures, one shows a bacillary angiomatosis lesion (Panels A and B) and one shows a clinically indistinguishable Kaposi's sarcoma lesion. It is associated with lytic bone lesions. Peliosis hepatis and lymph node involvement are linked with B henselae. The pathogenesis of bacillary angiomatosis includes early blood-borne dissemination of organisms. Bartonella organisms readily attach to and may enter erythrocytes. It appears as papules or nodules that are usually purplish to bright red and often resemble Kaposi's sarcoma. The lesions are firm and non blanching. They can occur anywhere on the body in numbers ranging from one to hundreds but are rarely seen on the palms, soles, or in the mouth. Bacillay angiomatosis is potentially lethal but shows an excellent response to antibiotics such as erythromycin.

Causes of Bacillary Angiomatosis

The common causes and risk factor's of Bacillary angiomatosis include the following:

• Bacillary angiomatosis is a bacterial infection caused by either Bartonella henselae or Bartonella quintana.
• Cytotoxic chemotherapy.
• Organ transplantations.
• Exposure to body and hair lice.
• HIV infection.

Symptoms of Bacillary Angiomatosis

Some symptoms related to Bacillary angiomatosis infection are as follows:

• Fever and chills.
• Weight loss.
• Night sweats.
• Abdominal pain.
• Nausea and vomiting (peliosis hepatis).
• Raised red or purple lesions in the skin that bleed when traumatized.
• Fatigue.
• Inflammation and soreness of the lymph nodes (lymphadenitis).

Treatment of Bacillary Angiomatosis

• Other oral antibiotics and antituberculosis drugs, including tetracycline, trimethoprim-sulfamethoxazole, and rifampin, may also be effective.
• Acetaminophen (Tylenol) may relieve pain, aches, and fever over 101°F.
• Warm, moist compresses can be applied to tender, swollen lymph nodes.
• Cryotherapy, electrodesiccation and curettage, and surgical excision of solitary cutaneous lesions can be useful as adjunctive therapy.
• Doxycycline may also be used.

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