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Bacillary angiomatosis with atypical clinical presentation in an immunocompetent patient  [cached]
Bernabeu-Wittel J,Luque R,Corbí R,Mantrana-Bermejo M
Indian Journal of Dermatology, Venereology and Leprology , 2010,
Abstract: Bacillary angiomatosis is a recently described infectious disease that usually affects immunosupressed hosts with a previous history of contact with cats. We report a rare case of bacillary angiomatosis in an immunocompetent 59-year-old woman with no history of previous exposure to cats, and atypical clinical features (fever and subcutaneous nodules with ulceration on the left ankle). Histopathology of the lesion showed extensive ulceration and reactive tumor-like vascular proliferation of the blood vessels with swollen endothelial cells and an inflammatory infiltrate including neutrophils and lymphocytes in the dermis and subcutis. Staining with the Warthin-Starry method demonstrated the presence of clustered bacilli located in the extracellular matrix adjacent to the proliferating endothelial cells. Diagnosis was confirmed with the detection of Bartonella spp. DNA in the affected skin and in bone marrow using polymerase chain reaction.
Bacillary angiomatosis in HIV-positive patient from Northeastern Brazil: a case report
Justa, Renata Félix da;Carneiro, Adriana Banhos;Rodrigues, Jorge Luiz Nobre;Cavalcante, Andréia;Gir?o, Evelyne Santana;Silva, Paulo Sergio;Valen?a Júnior, José Telmo;Menezes, Dalgimar Beserra de;Leit?o, Terezinha do Menino Jesus Silva;
Revista da Sociedade Brasileira de Medicina Tropical , 2011, DOI: 10.1590/S0037-86822011000500025
Abstract: it is a report of disseminated bacillary angiomatosis (ba) in a 23-year-old female patient, who is hiv-positive and with fever, weight loss, hepatomegaly, ascites, and papular-nodular skin lesions. the clinical and diagnostic aspects involved in the case were discussed. bacillary angiomatosis must always be considered in the diagnosis of febrile cutaneous manifestations in aids.
Bacillary Angiomatosis and Bacteremia due to Bartonella quintana in a Patient with Chronic Lymphocytic Leukemia  [PDF]
Rosamaria Fulchini,Guido Bloemberg,Katia Boggian
Case Reports in Infectious Diseases , 2013, DOI: 10.1155/2013/694765
Abstract: We present a 63-year-old man treated with alemtuzumab for chronic lymphocytic leukemia who developed multiple angiomatous papules and fever. Real-time polymerase chain reaction (RT-PCR) from a skin lesion and blood sample revealed Bartonella quintana as causative agent confirming the diagnosis of bacillary angiomatosis with bacteremia. Treatment with doxycycline, initially in combination with gentamicin, led to complete resolution of the lesions. This case shows the importance of considering bacillary angiomatosis as a rare differential diagnosis of angiomatous lesions in the immunocompromised patient, particularly in chronic lymphocytic leukemia and following lymphocyte depleting treatments as alemtuzumab. 1. Introduction Bacillary angiomatosis is a rare vasculoproliferative disorder due to Bartonella henselae or Bartonella quintana. The disease usually manifests as cutaneous angioma-like tumour. Lesions may be solitary or multiple and dissemination to visceral organs can occur. Bone lesions and subcutaneous masses are associated with B. quintana, whereas peliosis hepatis and lymph node lesions are associated with B. henselae [1]. Cases were usually described in HIV infected individuals. Although less common, the infection was reported in immunocompetent patients and in otherwise immunocompromised conditions such as solid organ transplantation and oncology patients, particularly in chronic lymphocytic leukemia [2, 3]. Because of its potentially life-threatening course, early diagnosis and adequate treatment are crucial. To our knowledge, we describe the first case of bacillary angiomatosis and bacteremia due to B. quintana in a patient with chronic lymphocytic leukemia. 2. Case Presentation A 63-year-old man was admitted for evaluation of multiple nonpruritic skin lesions that had been present for 1 month on his arms, legs, trunk, and face. His medical history was significant for chronic lymphocytic leukemia with longstanding profound neutropenia, anemia, and thrombocytopenia. He had previously been treated with chlorambucil and prednisone, as well as cladribine, rituximab, and bendamustine. At the time of presentation, he had been receiving alemtuzumab for 4 months. Current medication included prophylaxis with trimethoprim sulfamethoxazole as well as valacyclovir, and treatment with voriconazole for probable invasive pulmonary aspergillosis diagnosed during a previous febrile neutropenic episode. There had been several other episodes of neutropenic fever without specific infectious focus. Physical examination showed multiple nontender cutaneous
Angiomatosis bacilar por Bartonella quintana en un paciente con infección por virus de inmunodeficiencia humana Bacillary angiomatosis caused by Bartonella quintana in an human immunodeficiency virus positive patient  [cached]
Patricia Vásquez T,Leonardo Chanqueo C,Patricia García C,Helena Poggi M
Revista chilena de infectología , 2007,
Abstract: Reportamos el primer caso de angiomatosis bacilar por Bartonella quintana en un paciente con infección por VIH en nuestro país. Este corresponde a un hombre de 27 a os, heterosexual, indigente, seropositivo para VIH conocido desde septiembre de 2003, en control irregular. En abril de 2005, el paciente desarrolló un aumento progresivo de volumen en la región frontal y aparición de pápulas eritematosas en las extremidades, que luego se extendieron a la cara, tórax y mucosas, tornándose nodulares y violáceas. El diagnóstico de angiomatosis bacilar se planteó inicialmente por el cuadro clínico del paciente, siendo confirmado por serología y tinción de Warthin Starry positiva en la biopsia de piel. El agente causal se identificó como Bartonella quintana por RPC universal para el gen del 16S ARNr de un nódulo cutáneo. Se inició terapia antimicrobiana con azitromicina y ciprofloxacina, además de terapia antiretroviral, con desaparición de las lesiones en forma progresiva We report the first case of bacillary angiomatosis due to Bartonella quintana affecting a Chilean a HIV positive patient in Chile. He was a 27 years old, heterosexual male, indigentman known to be HIV positive serological status known from September, 2003, under irregular medical control. On April, 2005, he presented a progressive abscess in the frontal region and erythematous papules in the extremities, that extended to face, thorax and mucoses, becoming nodular and violaceous lesions. Bacillary angiomatosis diagnosis was initially sustained on account of the clinical manifestations, and was confirmed by serology and Warthin Starry staining from a skin biopsy. The etiological agent was identified as Bartonella quintana through universal RPC performed from a cutaneous nodule to detect 16S rRNA gen. Azithromycin plus ciprofloxacin was started, besides of anti retroviral therapy antiretroviral, with the lesions being progressively disappearing
Diffuse Myelitis after Treatment of Cerebral Aspergillosis in an Immune Competent Patient
Reza Mollahoseini,Mahdi Nikoobakht
Acta Medica Iranica , 2011,
Abstract: Presentation of an unusual case of cerebral aspergillosis in an immune competent patient who was treated successfully but symptoms and signs of a demyelinating process following initial recovery has been occurred. A 29-year-old male with focal seizure. Brain MRI revealed small multiple hemispheric and dural lesions. An open biopsy was conducted. Histological evaluation revealed hyphe-like structure in the necrotic area, within vessel walls, and lumina, suggestive aspergillus fumigatus . Furthermore, brancheal hyphae in potassium hydrxide15% and colonies on sabourud dextrose agar were observed. Based of the above findings the patient underwent anti fungal therapy. The patient recovered and continued a normal life however a follow up MRI was performed after 3 months from recovery. No significant abnormality was observed from the MRI procedure. One month later the patient developed signs and symptoms of spinal cord involvement which seemed to be the result of myelitis. A brain MR showed no abnormalities .Therefore it seemed reasonable to administer corticosteroid as a treatment for suspected active demyelinating process. During the above treatment, signs and symptoms of myelopathy disappeared and a whole spine MRI showed remarkable improvement.
Angiomatosis bacilar por Bartonella quintana como primera manifestación de infección por VIH: Report of one case Bacillary angiomatosis
Pablo Uribe,M. Elvira Balcells,Laura Giesen,Consuelo Cárdenas
Revista médica de Chile , 2012,
Abstract: Background: Bacillary angiomatosis is an unusual infectious disease, with angioproliferative lesions, typical of immunocompromised patients. It is caused by Bartonella quintana and Bartonella henselae, two infectious agents of the genus Bartonella, which trigger variable clinical manifestations, including cutaneous vascular and purpuric lesions, and regional lymphadenopathy, and even a systemic disease with visceral involvement. We report a 38-year-old HIV positive male presenting with a history of six months of cutaneous growing purple angiomatous lesions, located also in nasal fossae, rhi-nopharynx and larynx. The skin biopsy was compatible with bacillary angiomatosis. Polymerase chain reaction of a tissue sample showed homology with B. quintana strain Toulouse. The patient was treated with azithromycin and ciprofloxacin with a favorable evolution.
Bacillary angiomatosis: description of 13 cases reported in five reference centers for AIDS treatment in Rio de Janeiro, Brazil
GAZINEO, Jorge L. D.;TROPE, Beatriz M.;MACEIRA, Juan P.;MAY, Sílvia B.;COELHO, Janice M. C. de O.;LAMBERT, John S.;NOGUEIRA, Susie A.;
Revista do Instituto de Medicina Tropical de S?o Paulo , 2001, DOI: 10.1590/S0036-46652001000100001
Abstract: the aim of this case series was to describe the clinical, laboratory and epidemiological characteristics and the presentation of bacillary angiomatosis cases (and/or parenchymal bacillary peliosis) that were identified in five public hospitals of rio de janeiro state between 1990 and 1997; these cases were compared with those previously described in the medical literature. thirteen case-patients were enrolled in the study; the median age was 39 years and all patients were male. all patients were human immunodeficiency virus type 1 (hiv-1) infected and they had previous or concomitant hiv-associated opportunistic infections or malignancies diagnosed at the time bacillary angiomatosis was diagnosed. median t4 helper lymphocyte counts of patients was 96 cells per mm3. cutaneous involvement was the most common clinical manifestation of bacillary angiomatosis in this study. clinical remission following appropriate treatment was more common in our case series than that reported in the medical literature, while the incidence of relapse was similar. the frequency of bacillary angiomatosis in hiv patients calculated from two of the hospitals included in our study was 1.42 cases per 1000 patients, similar to the frequencies reported in the medical literature. bacillary angiomatosis is an unusual opportunistic pathogen in our setting.
Bacillary angiomatosis: description of 13 cases reported in five reference centers for AIDS treatment in Rio de Janeiro, Brazil  [cached]
GAZINEO Jorge L. D.,TROPE Beatriz M.,MACEIRA Juan P.,MAY Sílvia B.
Revista do Instituto de Medicina Tropical de S?o Paulo , 2001,
Abstract: The aim of this case series was to describe the clinical, laboratory and epidemiological characteristics and the presentation of bacillary angiomatosis cases (and/or parenchymal bacillary peliosis) that were identified in five public hospitals of Rio de Janeiro state between 1990 and 1997; these cases were compared with those previously described in the medical literature. Thirteen case-patients were enrolled in the study; the median age was 39 years and all patients were male. All patients were human immunodeficiency virus type 1 (HIV-1) infected and they had previous or concomitant HIV-associated opportunistic infections or malignancies diagnosed at the time bacillary angiomatosis was diagnosed. Median T4 helper lymphocyte counts of patients was 96 cells per mm3. Cutaneous involvement was the most common clinical manifestation of bacillary angiomatosis in this study. Clinical remission following appropriate treatment was more common in our case series than that reported in the medical literature, while the incidence of relapse was similar. The frequency of bacillary angiomatosis in HIV patients calculated from two of the hospitals included in our study was 1.42 cases per 1000 patients, similar to the frequencies reported in the medical literature. Bacillary angiomatosis is an unusual opportunistic pathogen in our setting.
Angiomatosis bacilar por Bartonella quintana en un paciente con infección por virus de inmunodeficiencia humana
Vásquez T,Patricia; Chanqueo C,Leonardo; García C,Patricia; Poggi M,Helena; Ferrés G,Marcela; Bustos M,Marisol; Piottante B,Antonio;
Revista chilena de infectología , 2007, DOI: 10.4067/S0716-10182007000200012
Abstract: we report the first case of bacillary angiomatosis due to bartonella quintana affecting a chilean a hiv positive patient in chile. he was a 27 years old, heterosexual male, indigentman known to be hiv positive serological status known from september, 2003, under irregular medical control. on april, 2005, he presented a progressive abscess in the frontal region and erythematous papules in the extremities, that extended to face, thorax and mucoses, becoming nodular and violaceous lesions. bacillary angiomatosis diagnosis was initially sustained on account of the clinical manifestations, and was confirmed by serology and warthin starry staining from a skin biopsy. the etiological agent was identified as bartonella quintana through universal rpc performed from a cutaneous nodule to detect 16s rrna gen. azithromycin plus ciprofloxacin was started, besides of anti retroviral therapy antiretroviral, with the lesions being progressively disappearing
An atypical case of cystic angiomatosis
Revista Cubana de Ortopedia y Traumatolog?-a , 2003,
Abstract: the paper presents a patient with bone cystic angiomatosis that is an infrequent benign tumor of vascular origin atypically located in the radius and the ulna. the clinical picture and the applied treatment are set forth.
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