Bacillary angiomatosis is a systemic disease characterized by lesions similar to those of Karposi's sarcoma on the skin mucous membrane surfaces, liver, spleen and other organs. It is an infection of bacterial origin with Bartonella quintana and Bartonella henselae (cause of cat scratch disease and also known as Rochalimaea henselae). The disease is rarely seen in healthy immunocompetent people. It mainly affects immunocompromised patients, particularly those with AIDS or HIV.
How is bacillary angiomatosis contracted?
Bacillary angiomatosis is also caused by Bartonella quintana and Bartonella henselae. It is usually the result of exposure to cats infested with fleas with Bartonella henselae and the human body louse with Bartonella quintana (the cause of trench fever in soldiers during World War I). Today, the disease occurs mainly in AIDS patients. It may also be a complication of scratch disease in immunocompetent patients.
What are the signs and symptoms of bacillary angiomatosis?
The first is generally the appearance of numerous pointed purple to bright red spots and nodules up to 10 cm above or just under the skin. These lesions resemble Kaposi sarcoma and the disease is often confused with this. There may be between 1 and 100 lesions on any part of the body, although they are rarely found on the palms, soles, or mouth. Lesions can be pinhead-sized spots or nodules up to 10 cm in diameter. The nodules are firm lumps and do not turn white with firm pressure. If injured, the lesions bleed profusely.
As the number of lesions increases, the patient may develop high fever, pain, and swelling. lymph nodes, nausea, vomiting, sweating, chills and lack of appetite.
The infection can also cause blood vessels grow out of control And form tumor-as masses in other organs, including bones, liver, spleen, lymph nodes, heart, gastrointestinal tract, and respiratory tract, where airway obstruction may occur. The condition can be life-threatening if not diagnosed and treated immediately.
What is the treatment of bacillary angiomatosis?
Bacillary angiomatosis is effectively treated with antibiotics. The erythromycin appears to be the antibiotic of choice and is administered until the lesions resolve, usually within 3-4 weeks of starting therapy. Other antibiotics used include doxycycline, trimethoprim + sulfamethoxazole, tetracycline and rifampicin.
Large lymph nodes or pus-filled blisters may need to be drained. Supportive therapy includes hydration and pain relievers for pain and fever. Warm, moist compresses on the affected nodes can decrease swelling and tenderness.
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