Bacillary angiomatosis (BA) is a form of angiomatosis associated with bacteria of the genus '' Bartonella''.

Symptoms

Cutaneous BA is characterised by the presence of lesions on or under the skin. Appearing in numbers from one to hundreds, these lesions may take several forms: * papules or nodules which are red, globular and non-blanching, with a vascular appearance * purplish nodules sufficiently similar to

Kaposi's sarcoma Kaposi's sarcoma (KS) is a type of cancer that can form masses on the skin, in lymph nodes, in the mouth, or in other organs. The skin lesions are usually painless, purple and may be flat or raised. Lesions can occur singly, multiply in a limite ...

that a

biopsy A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, an interventional radiologist, or an interventional cardiology, interventional cardiologist. The process involves the extraction of sampling (medicine), sample ...

may be required to verify which of the two it is * a purplish lichenoid plaque * a subcutaneous nodule which may have ulceration, similar to a bacterial

abscess An abscess is a collection of pus that has built up within the tissue of the body, usually caused by bacterial infection. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pre ...

While cutaneous BA is the most common form, it can also affect several other parts of the body, such as the brain, bone, bone marrow, lymph nodes, gastrointestinal tract, respiratory tract, spleen, and liver. Symptoms vary depending on which parts of the body are affected; for example, those whose livers are affected may have an enlarged liver and

fever Fever or pyrexia in humans is a symptom of an anti-infection defense mechanism that appears with Human body temperature, body temperature exceeding the normal range caused by an increase in the body's temperature Human body temperature#Fever, s ...

, while those with osseous BA experience intense pain in the affected area.

Presentation

BA is characterised by the proliferation of blood vessels, resulting in them forming tumour-like masses in the skin and other organs.

Causes

It is caused by either '' Bartonella henselae'' or '' B. quintana''. * ''B. henselae'' is most often transmitted through a

cat The cat (''Felis catus''), also referred to as the domestic cat or house cat, is a small domesticated carnivorous mammal. It is the only domesticated species of the family Felidae. Advances in archaeology and genetics have shown that the ...

scratch or bite, though

tick Ticks are parasitic arachnids of the order Ixodida. They are part of the mite superorder Parasitiformes. Adult ticks are approximately 3 to 5 mm in length depending on age, sex, and species, but can become larger when engorged. Ticks a ...

s and

flea Flea, the common name for the order (biology), order Siphonaptera, includes 2,500 species of small flightless insects that live as external parasites of mammals and birds. Fleas live by hematophagy, ingesting the blood of their hosts. Adult f ...

s may also act as vectors. * ''B. quintana'' is usually transmitted by

lice Louse (: lice) is the common name for any member of the infraorder Phthiraptera, which contains nearly 5,000 species of wingless parasitic insects. Phthiraptera was previously recognized as an order, until a 2021 genetic study determined th ...

. It can manifest in people with

AIDS The HIV, human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a Preventive healthcare, pr ...

and rarely appears in those who are immunocompetent.

Diagnosis

Diagnosis is based on a combination of clinical features and biopsy. Neutrophilic infiltrate.

Treatment and prevention

While curable, BA is potentially fatal if not treated. BA responds dramatically to several antibiotics. Usually,

erythromycin Erythromycin is an antibiotic used for the treatment of a number of bacterial infections. This includes respiratory tract infections, skin infections, chlamydia infections, pelvic inflammatory disease, and syphilis. It may also be used ...

will cause the skin lesions to gradually fade away in the next four weeks, resulting in complete recovery.

Doxycycline Doxycycline is a Broad-spectrum antibiotic, broad-spectrum antibiotic of the Tetracycline antibiotics, tetracycline class used in the treatment of infections caused by bacteria and certain parasites. It is used to treat pneumonia, bacterial p ...

may also be used. However, if the infection does not respond to either of these, the medication is usually changed to

tetracycline Tetracycline, sold under various brand names, is an antibiotic in the tetracyclines family of medications, used to treat a number of infections, including acne, cholera, brucellosis, plague, malaria, and syphilis. It is available in oral an ...

. If the infection is serious, then a bactericidal medication may be coupled with the antibiotics If a cat is carrying ''Bartonella henselae'', then it may not exhibit any symptoms. Cats may be bacteremic for weeks to years, but infection is more common in young cats. Transmission to humans is thought to occur via flea feces inoculated into a cat scratch or bite, and transmission between cats occurs only in the presence of fleas. Therefore, elimination and control of fleas in the cat's environment are key to prevention of infection in both cats and humans.

History

The condition that later became known as bacillary angiomatosis was first described by Stoler and associates in 1983. Being unaware of its infectious origin, it was originally called ''epithelioid angiomatosis''. Following documentation of bacilli in Warthin-Starry stains and by electron microscopy in a series of cases by LeBoit and colleagues, the term bacillary angiomatosis was widely adopted.

References

External links

{{Bacterial cutaneous infections Bacterium-related cutaneous conditions