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1/43. Bacillary angiomatosis by bartonella quintana in an HIV-infected patient.

    Bacillary angiomatosis and bacillary peliosis are opportunistic infections caused by bartonella henselae and bartonella quintana, which occur in patients with late-stage infection. We report a case of bacillary angiomatosis in an HIV-infected patient with skin, bone, and probably liver involvement, The identification of the agent (B quintana ) was done by polymerase chain reaction in the skin specimen. The patient had complete regression of all lesions after a 6-month regimen of oral erythromycin.
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keywords = angiomatosis
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2/43. Bacillary angiomatosis affecting the oral cavity. Report of two cases and review.

    Bacillary angiomatosis (BA) is an infectious disease characterized by proliferative vascular lesions; it mainly affects HIV-positive patients. Multiple cutaneous nodular lesions together with fever, chills, malaise, anorexia, vomiting and headache are the most important clinical manifestations. It may also involve the heart, liver, spleen, bones, lung, muscles, lymph nodes, central nervous system and other organs. erythromycin, 500 mg four times a day, is the drug of choice. The importance of this lesion lies in its clinical and histological similarity with other diseases. Cutaneous and oral lesions of BA clinically resemble Kaposi's sarcoma (KS). Histopathologically, BA may be confused with angiosarcoma, pyogenic granuloma and epithelioid hemangioma. We report two HIV-positive men with BA lesions in the oral mucosa. diagnosis was confirmed by biopsy and Warthin-Starry silver staining.
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keywords = angiomatosis
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3/43. pyomyositis associated with bacillary angiomatosis in a patient with HIV infection.

    Bacillary angiomatosis is an opportunistic infection occurring predominantly in patients with HIV infection. The manifestations of this vasculoproliferative disorder vary markedly. Virtually any organ site may be involved, singly or multiply. However cutaneous involvement can be a valuable clue to its diagnosis. We report a case of bacillary angiomatosis in an HIV-infected patient presenting as isolated pyomyositis of the right leg. The rarity of such a presentation and paucity of cutaneous lesions, as in our case, may render timely diagnosis elusive and difficult. Its recognition however, is important since bacillary angiomatosis, if untreated, is potentially fatal.
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keywords = angiomatosis
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4/43. A case report of bacillary angiomatosis in a patient infected with human immunodeficiency virus.

    A man infected with human immunodeficiency virus (HIV) presented with a few-month history of an enlarging friable growth on the medial area of the left foot and a one-week history of bilateral lower extremity edema. Clinical and histologic examination led to a diagnosis of bacillary angiomatosis, and the patient responded to antibiotic therapy We provide an overview of bacillary angiomatosis, a rare disorder that affects immunocompromised patients with CD4 cell counts less than 100/microL.
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5/43. AIDS presenting with cutaneous Kaposi's sarcoma and bacillary angiomatosis in the bone marrow mimicking Kaposi's sarcoma.

    Kaposi's sarcoma (KS) and bacillary angiomatosis (BA) may be histologically similar. A precise diagnosis is required because of the different management of these diseases. KS or BA involving bone marrow is rare in patients with and without acquired immune deficiency syndrome (AIDS). We report the case of a 40-year-old human immunodeficiency virus (HIV)-positive homosexual male who presented with small KS lesions in the skin and BA in the bone marrow that histologically were similar. Laboratory evaluation revealed anemia and thrombocytopenia; CD4 count was 103/mm3, and the viral load was 750,000 hiv-1 mRNA copies per milliliter in plasma. bartonella henselae, the etiologic agent of BA, was isolated from a blood culture. dna sequences of human herpesvirus-8 (HHV-8), the putative etiologic agent of KS, were identified by polymerase chain reaction (PCR) in skin and bone marrow specimens, but antibody anti-HHV-8-encoded protein ORF73, localized signals only in the skin-KS lesion. The patient received clarithromycin and cefotetan for the BA, and antiretroviral therapy for the HIV infection. The skin lesions gradually regressed, the hiv-1 mRNA copy number decreased to less than 400 per milliliter and the cd4 lymphocyte count increased to 665/mm3. In conclusion, vascular lesions of BA and KS may be clinically and histologically similar, both may be associated with advanced AIDS, and an accurate diagnosis is required because of their different management.
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keywords = angiomatosis
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6/43. Localization of mycobacterium avium-intracellulare within a skin lesion of bacillary angiomatosis in a patient with AIDS.

    We report a 39-year-old man who had AIDS and who presented with an unusual cutaneous vascular lesion, which was clinically thought to be Kaposi's sarcoma. Histologically, the lesion was characterized by capillary proliferation and a mixed inflammatory infiltrate that included numerous histiocytes. The lesion was found to contain slender intracellular acid-fast bacilli, as well as plump extracellular Warthin-Starry-positive bacilli. The acid-fast bacilli were confirmed to be mycobacterium avium-intracellulare by subsequent positive blood cultures for this organism. To further investigate the lesion, polymerase chain reaction dna amplification and sequencing was performed, and the lesion was found to contain dna sequences identical to those previously established for the agent of bacillary angiomatosis. The lesion is thought to represent a lesion of bacillary angiomatosis with secondary involvement by M. avium-intracellulare.
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keywords = angiomatosis
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7/43. Upper gastrointestinal bacillary angiomatosis causing hematemesis: a case report.

    A 38-year-old HIV-positive woman presented with massive hematemesis on initial admission to hospital. endoscopy revealed ulcerated nodular lesions in the esophagus, stomach, and duodenum. The clinical impression was of Kaposi's sarcoma. The stomach was biopsied when the patient re-presented, and another endoscopy was performed. The biopsy showed mucosal ulceration with a proliferation of vascular channels associated with neutrophils and clumps of purplish, granular bacterial colonies, which were highlighted by a Warthin-Starry stain. The histopathological features were typical of bacillary angiomatosis. This case highlights bacillary angiomatosis involving the gastrointestinal tract at multiple sites, the cause of massive upper gastrointestinal hemorrhage that was the initial presentation of an HIV-positive patient, and the occurrence of visceral bacillary angiomatosis in the absence of cutaneous lesions.
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ranking = 1.1666666666667
keywords = angiomatosis
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8/43. Isolation of Rochalimaea species from cutaneous and osseous lesions of bacillary angiomatosis.

    BACKGROUND. Bacillary angiomatosis is characterized by vascular lesions, which occur usually in patients infected with the human immunodeficiency virus (HIV). A newly described gram-negative organism, Rochalimaea henselae, has been associated with cutaneous bacillary angiomatosis, but no organism has been isolated and cultivated directly from cutaneous tissue. methods. We used two methods to isolate the infecting bacterium from four HIV-infected patients with cutaneous lesions suggestive of bacillary angiomatosis: cultivation with eukaryotic tissue-culture monolayers and direct plating of homogenized tissue onto agar. The patients' blood was cultured with the lysis-centrifugation method. Isolates recovered from skin and blood were identified by sequencing all or part of the 16S ribosomal rna gene amplified with the polymerase chain reaction. RESULTS. R. quintana, historically known as the agent of trench fever, was isolated from cutaneous lesions in three patients, after tissue homogenates were cultivated with endothelial-cell monolayers; R. henselae was isolated from a cutaneous lesion in one patient. In two patients, R. quintana was isolated from both cutaneous tissue and blood; in one patient it was also isolated from bone. CONCLUSIONS. In bacillary angiomatosis, either of two species of rochalimaea--R. quintana or R. henselae--can be isolated from cutaneous lesions or blood, providing an additional method of diagnosis.
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keywords = angiomatosis
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9/43. Bacillary angiomatosis with cytomegaloviral and mycobacterial infections of the palpebral conjunctiva in a patient with AIDS.

    We report the clinical and histopathologic findings of bacillary angiomatosis involving the palpebral conjunctiva with concomitant infection by cytomegalovirus and Mycobacterium species in a patient with acquired immune deficiency syndrome. After debulking, the conjunctival tissue was studied with the use of light and electron microscopy; stains for bacteria, acid-fast bacilli, and Bartonella species; and immunohistochemical studies for cytomegalovirus and herpes simplex virus. We observed the typical histopathologic findings of bacillary angiomatosis, the presence of bacilli stained by the Steiner and Steiner method, and the electron microscopic demonstration of bacilli consistent with Bartonella species. immunohistochemistry confirmed infection with cytomegalovirus, which had been suggested by characteristic cytologic abnormalities. Acid-fast bacilli were also found in the excised tissue. patients with bacillary angiomatosis of the conjunctiva may have infections with multiple additional microorganisms.
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ranking = 1.1666666666667
keywords = angiomatosis
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10/43. Bacillary angiomatosis associated with pseudoepitheliomatous hyperplasia.

    Bacillary angiomatosis is an opportunistic bacterial infection caused by either bartonella henselae or B. quintana. The classic histologic presentation of bacillary angiomatosis involves three components: a lobular proliferation of capillaries with enlarged endothelial cells, neutrophilic debris, and clumps of finely granular material identified as bacteria with staining techniques. Pseudoepitheliomatous hyperplasia is a histologic reaction pattern characterized by epithelial proliferation in response to a variety of stimuli, including mycobacterial, fungal, and bacterial infections. We describe a case of bacillary angiomatosis associated with pseudoepitheliomatous hyperplasia in an immunocompromised patient with acquired immunodeficiency syndrome. Histologic examination of a finger lesion demonstrated a capillary proliferation with neutrophilic debris and characteristic amorphous granular deposits. Warthin-Starry and Giemsa staining revealed clumps of coccobacilli. Cervical lymph node tissue also revealed organisms identified as Bartonella with PCR techniques. Stains and cultures for acid fast bacilli, fungus, and bacteria were negative. To our knowledge, there has been only one other report of bacillary angiomatosis presenting with pseudoepitheliomatous hyperplasia. We conclude that the differential diagnosis of entities associated with pseudoepitheliomatous hyperplasia should be expanded to include bacillary angiomatosis.
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ranking = 1.5
keywords = angiomatosis
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