Bacillary angiomatosis

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Bacillary angiomatosis
Bartonella.jpg
Bartonella (bacterial species which causes this condition)
Specialty Infectious disease   Blue pencil.svg

Bacillary angiomatosis (BA) is a form of angiomatosis associated with bacteria of the genus Bartonella . [1]

Angiomatosis benign vascular malformation involving skin, subcutaneous tissue, skeletal muscle and occasionally bone

Angiomatosis is a non-neoplastic condition characterised by nests of proliferating capillaries arranged in a lobular pattern, displacing adjacent muscle and fat. It consists of many angiomas.

<i>Bartonella</i> genus of bacteria

Bartonella is a genus of Gram-negative bacteria. It is the only genus in the family Bartonellaceae. Facultative intracellular parasites, Bartonella species can infect healthy people, but are considered especially important as opportunistic pathogens. Bartonella species are transmitted by vectors such as ticks, fleas, sand flies, and mosquitoes. At least eight Bartonella species or subspecies are known to infect humans.

Contents

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:[ citation needed ]

Kaposis sarcoma connective tissue cancer

Kaposi's sarcoma (KS) is a type of cancer that can form masses in the skin, lymph nodes, or other organs. The skin lesions are usually purple in color. They can occur singularly, in a limited area, or be widespread. It may worsen either gradually or quickly. Lesions may be flat or raised. Human herpesvirus 8 (HHV8) is found in the lesions of all those who are affected. Risk factors include poor immune function, either as a result of disease or specific medications, and chronic lymphedema.

Biopsy medical test involving sampling of cells or tissues for examination

A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist involving extraction of sample cells or tissues for examination to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. An incisional biopsy or core biopsy samples a portion of the abnormal tissue without attempting to remove the entire lesion or tumor. When a sample of tissue or fluid is removed with a needle in such a way that cells are removed without preserving the histological architecture of the tissue cells, the procedure is called a needle aspiration biopsy. Biopsies are most commonly performed for insight into possible cancerous and inflammatory conditions.

Abscess localized collection of pus that has built up within the tissue of the body

An abscess is a collection of pus that has built up within the tissue of the body. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pressed. The area of redness often extends beyond the swelling. Carbuncles and boils are types of abscess that often involve hair follicles, with carbuncles being larger.

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, while those with osseous BA experience intense pain in the affected area.[ citation needed ]

Hepatomegaly symptom

Hepatomegaly is the condition of having an enlarged liver. It is a non-specific medical sign having many causes, which can broadly be broken down into infection, hepatic tumours, or metabolic disorder. Often, hepatomegaly will present as an abdominal mass. Depending on the cause, it may sometimes present along with jaundice.

Fever common medical sign characterized by elevated body temperature

Fever, also known as pyrexia and febrile response, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using values between 37.5 and 38.3 °C. The increase in set point triggers increased muscle contractions and causes a feeling of cold. This results in greater heat production and efforts to conserve heat. When the set point temperature returns to normal, a person feels hot, becomes flushed, and may begin to sweat. Rarely a fever may trigger a febrile seizure. This is more common in young children. Fevers do not typically go higher than 41 to 42 °C.

Presentation

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

Causes

It is caused by either Bartonella henselae or B. quintana . [2]

<i>Bartonella henselae</i> species of bacterium

Bartonella henselae, formerly Rochalimæa, is a proteobacterium that is the causative agent of cat-scratch disease (bartonellosis).

Bartonella quintana, originally known as Rochalimaea quintana, and "Rickettsia quintana", is a micro-organism transmitted by the human body louse. This microorganism is the causative agent of the well known trench fever. This bacterium caused outbreaks of trench fever affecting 1 million soldiers in Europe during World War I.

It can manifest in people with AIDS [4] and rarely appears in those who are immunocompetent.[ citation needed ]

Diagnosis

Diagnosis is based on a combination of clinical features and biopsy. [1]

Treatment and prevention

While curable, BA is potentially fatal if not treated. [1] BA responds dramatically to several antibiotics. Usually, erythromycin will cause the skin lesions to gradually fade away in the next four weeks, resulting in complete recovery. Doxycycline may also be used. However, if the infection does not respond to either of these, the medication is usually changed to tetracycline. If the infection is serious, then a bactericidal medication may be coupled with the antibiotics[ citation needed ]

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.[ citation needed ]

History

The condition that later became known as bacillary angiomatosis was first described by Stoler and associates in 1983. [5] Being unaware of its infectious origin, it was originally called epithelioid angiomatosis. [6] 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. [7]

See also

Related Research Articles

Trench fever is a moderately serious disease transmitted by body lice. It infected armies in Flanders, France, Poland, Galicia, Italy, Salonika, Macedonia, Mesopotamia, Russia and Egypt in World War I. Three noted sufferers during WWI were the authors J. R. R. Tolkien, A. A. Milne, and C. S. Lewis. From 1915 to 1918 between one-fifth and one-third of all British troops reported ill had trench fever while about one-fifth of ill German and Austrian troops had the disease. The disease persists among the homeless. Outbreaks have been documented, for example, in Seattle and Baltimore in the United States among injection drug users and in Marseille, France, and Burundi.

Granuloma inflammation consisting of immune cells known as macrophages

A granuloma is a structure formed during inflammation that is found in many diseases. It is a collection of immune cells known as macrophages. Granulomas form when the immune system attempts to wall off substances it perceives as foreign but is unable to eliminate. Such substances include infectious organisms including bacteria and fungi, as well as other materials such as keratin and suture fragments.

Carrions disease infectious disease produced by Bartonella bacilliformis infection

Oroya fever or Carrion's disease is an infectious disease produced by Bartonella bacilliformis infection.

Hemangioendothelioma group of vascular neoplasms

Hemangioendotheliomas are a family of vascular neoplasms of intermediate malignancy.

Erythema nodosum skin disease

Erythema nodosum (EN), also known as subacute migratory panniculitis of Vilanova and Piñol, is an inflammatory condition characterized by inflammation of the fat cells under the skin, resulting in tender red nodules or lumps that are usually seen on both shins. It can be caused by a variety of conditions, and typically resolves spontaneously within 30 days. It is common in young people between 12–20 years of age.

Bartonellosis is an infectious disease produced by bacteria of the genus Bartonella. Bartonella species cause diseases such as Carrión´s disease, trench fever, cat-scratch disease, bacillary angiomatosis, peliosis hepatis, chronic bacteremia, endocarditis, chronic lymphadenopathy, and neurological disorders.

Penicilliosis is an infection caused by Penicillium marneffei.

Prurigo nodularis

Prurigo nodularis (PN), also known as nodular prurigo, is a skin disease characterised by pruritic (itchy) nodules which usually appear on the arms or legs. Patients often present with multiple excoriated lesions caused by scratching. PN is also known as Hyde prurigo nodularis, Picker's nodules, atypical nodular form of neurodermatitis circumscripta, lichen corneus obtusus.

Peliosis hepatis is an uncommon vascular condition characterised by multiple, randomly distributed, blood-filled cavities throughout the liver. The size of the cavities usually ranges between a few millimetres and 3 cm in diameter. In the past, it was a mere histological curiosity occasionally found at autopsies, but has been increasingly recognised with wide-ranging conditions from AIDS to the use of anabolic steroids. It also occasionally affects spleen, lymph nodes, lungs, kidneys, adrenal glands, bone marrow, and other parts of gastrointestinal tract.

Bartonella rochalimae is a recently discovered strain of Gram-negative bacteria in the genus Bartonella, isolated by researchers at the University of California, San Francisco (UCSF), Massachusetts General Hospital, and the United States Centers for Disease Control and Prevention. The bacterium is a close relative of Bartonella quintana, the microbe which caused trench fever in thousands of soldiers during World War I. Named after Brazilian scientist Henrique da Rocha Lima, B. rochalimae is also closely related to Bartonella henselae, a bacterium identified in the mid-1990s during the AIDS epidemic in San Francisco as the cause of cat scratch fever, which still infects more than 24,000 people in the United States each year.

Bartonella bacilliformis is a proteobacterium, Gram negative aerobic, pleomorphic, flagellated, motile, coccobacillary, 2–3 μm long, 0.2–0.5 μm wide, and a facultative intracellular bacterium.

Solitary pulmonary nodule small lesion in the lung

A solitary pulmonary nodule (SPN) or coin lesion is a mass in the lung smaller than 3 centimeters in diameter. It can be an incidental finding found in up to 0.2% of chest X-rays and around 1% of CT scans.

Majocchi's granuloma, which is a localized form of fungal folliculitis, is a skin condition characterized by a deep, pustular plaques and is a form of tinea corporis. Lesions often have a pink and scaly central component with pustules or folliculocentric papules at the periphery. The name Majocchi's comes from the Professor Domenico Majocchi who first discovered the disorder in 1883. Domenico Majocchi was a professor of dermatology at the University of Parma and later the University of Bologna. The most common dermatophyte is called Trichophyton rubrum. This disease commonly affects both immunocompetent and immunocompromised hosts. However, immunocompromised individuals have a higher risk.

Cat-scratch disease Human disease

Cat-scratch disease (CSD) is an infectious disease that results from a scratch or bite of a cat. Symptoms typically include a non-painful bump or blister at the site of injury and painful and swollen lymph nodes. People may feel tired, have a headache, or a fever. Symptoms typically begin within 3-14 days following infection.

Dieterle stain

The Dieterle stain is a way of marking tissue for microscopic examination. The key reagent of Dieterle stain is silver nitrate. It can stain microbes like Treponema pallidum in grey or black and background in yellow.

The stages of HIV infection are acute infection, latency and AIDS. Acute infection lasts for several weeks and may include symptoms such as fever, swollen lymph nodes, inflammation of the throat, rash, muscle pain, malaise, and mouth and esophageal sores. The latency stage involves few or no symptoms and can last anywhere from two weeks to twenty years or more, depending on the individual. AIDS, the final stage of HIV infection, is defined by low CD4+ T cell counts, various opportunistic infections, cancers and other conditions.

Bartonella clarridgeiae is a Gram-negative bacteria from the genus of Bartonella which was first isolated in the United States. Bartonella clarridgeiae is a zoonotic pathogen which can cause cat scratch disease.

Cat bite The bite of the domestic cat

Cat bites are bites inflicted upon humans, other cats, and other animals by the domestic cat. Though uncommon, sometimes cat bites can lead to complications and, very rarely, death.

References

  1. 1 2 3 "Bacillary Angiomatosis: Practice Essentials, Background, Pathophysiology". 2017-02-09.
  2. Koehler JE, Sanchez MA, Garrido CS, et al. (December 1997). "Molecular epidemiology of bartonella infections in patients with bacillary angiomatosis-peliosis". N. Engl. J. Med. 337 (26): 1876–83. doi:10.1056/NEJM199712253372603. PMID   9407154.
  3. Mateen FJ, Newstead JC, McClean KL (July 2005). "Bacillary angiomatosis in an HIV-positive man with multiple risk factors: A clinical and epidemiological puzzle". Can J Infect Dis Med Microbiol. 16 (4): 249–52. doi:10.1155/2005/230396. PMC   2095030 Lock-green.svg. PMID   18159553.
  4. Gasquet S, Maurin M, Brouqui P, Lepidi H, Raoult D (1998). "Bacillary angiomatosis in immunocompromised patients". AIDS. 12 (14): 1793–803. doi:10.1097/00002030-199814000-00011. PMID   9792380.
  5. Stoler MH, Bonfiglio TA, Steigbigel RT, Pereira M. An atypical subcutaneous infection associated with acquired immune deficiency syndrome. Am J Clin Pathol. 1983 Nov;80(5):714-8
  6. Cockerell CJ, Whitlow MA, Webster GF, Friedman-Kien AE. Epithelioid angiomatosis: a distinct vascular disorder in patients with the acquired immunodeficiency syndrome or AIDS-related complex. Lancet. 1987 Sep 19;2(8560):654-6
  7. LeBoit PE, Berger TG, Egbert BM, Beckstead JH, Yen TS, Stoler MH (1989). "Bacillary angiomatosis. The histopathology and differential diagnosis of a pseudoneoplastic infection in patients with human immunodeficiency virus disease". Am J Surg Pathol. 13 (11): 909–20. doi:10.1097/00000478-198911000-00001. PMC   1003203 Lock-green.svg. PMID   2802010.
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