II. Risk Factors

  1. AIDS (CD4 Count <100 cells/mm3)
  2. Immunocompromised patients on Chemotherapy or organ rejection medication

IV. Symptoms

  1. Fever
  2. Chills
  3. Anorexia
  4. Weight loss
  5. Gastrointestinal symptoms

V. Signs

  1. Skin Lesions that appear similar to Kaposi's Sarcoma
  2. Vascular lesions in form or Papules, Nodules or pedunculated

VI. Differential Diagnosis

VII. Diagnosis

  1. Bartonella Antibody titer increased (or by PCR)
  2. Biopsy shows bacillary organisms

VIII. Management

  1. Risks
    1. Jarisch-Herxheimer Reaction (first 48 hours)
    2. Avoid use of TMP-SMZ, Ciprofloxacin, Penicillin, Cephalosporins
  2. Uncomplicated infection (skin only)
    1. Treat for 3 months (skin lesions may resolve as early as in 1-3 weeks)
    2. Doxycycline 100 mg oral or IV twice daily (preferred) OR
    3. Erythromycin 500 mg every 6 hours
      1. Other Macrolides have been used (Azithromycin, Clarithromycin)
  3. Disseminated infection
    1. Treat for at least 4 months
    2. Doxycycline 100 mg oral or IV twice daily AND
    3. Rifampin 300 mg orally twice daily
  4. Relapsing infection
    1. Repeat antibiotic course as above AND
    2. Extend course for suppression until CD4 Count >200 for 6 months

IX. Complications

  1. Disseminated infection to bone, mucous membranes, CNS
  2. Bacterial Endocarditis
  3. Bacillary Peliosis (Liver Cystic lesions)

X. References

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Related Studies

Ontology: Angiomatosis, Bacillary (C0085434)

Definition (MSH) A reactive vascular proliferation that is characterized by the multiple tumor-like lesions in skin, bone, brain, and other organs. Bacillary angiomatosis is caused by infection with gram-negative Bartonella bacilli (such as BARTONELLA HENSELAE), and is often seen in AIDS patients and other IMMUNOCOMPROMISED HOSTS.
Concepts Disease or Syndrome (T047)
MSH D016917
SnomedCT 58213005
English Angiomatoses, Bacillary, Angiomatoses, Bacillary Epithelioid, Angiomatoses, Epithelioid, Angiomatosis, Bacillary, Angiomatosis, Bacillary Epithelioid, Angiomatosis, Epithelioid, Bacillary Angiomatoses, Bacillary Epithelioid Angiomatoses, Epithelioid Angiomatoses, Epithelioid Angiomatoses, Bacillary, Epithelioid Angiomatosis, Bacillary, Bacillary Angiomatosis, Angiomatosis bacillary, Angiomatosis, Bacillary [Disease/Finding], angiomatosis bacillary, bacillary angiomatosis, Bacillary angiomatosis, Bacillary angiomatosis (disorder), Bacillary Epithelioid Angiomatosis, Epithelioid Angiomatosis
Dutch angiomatose bacillair, bacillaire angiomatose, Angiomatosis, bacillaire, Angiomatosis, epitheloïde
German Angiomatosis durch Bazillen, bazillaere Angiomatose, Angiomatose, epitheloide, Angiomatose, bazilläre
Portuguese Angiomatose bacilar, Angiomatose Epitelioide, Angiotomatose bacilar, Angiomatose Bacilar
Swedish Angiomatos, bacillär
Japanese サイキンセイケッカンシュショウ, 血管腫症-細菌性, 細菌性血管腫症, 類上皮血管腫症, 血管腫症-類上皮
Czech angiomatóza epiteloidní, angiomatóza bacilární, Bacilární angiomatóza
Finnish Angiomatosis bacillaris
Italian Angiomatosi epitelioide bacillare, Angiomatosi epitelioide, Angiomatosi bacillare
Polish Naczyniakowatość nabłonkowata, Naczyniakowatość bakteryjna
Hungarian Angiomatosis bacillaris, bacillaris angiomatosis
Norwegian Bacillær angiomatose
Spanish angiomatosis bacilar (trastorno), angiomatosis bacilar, Angiomatosis bacilar, Angiomatosis Bacilar, Angiomatosis Epitelioide
French Angiomatose bacillaire, Angiomatose épithelioïde, Angiomatose épithélioïde bacillaire