bacillary angiomatosis

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Related to bacillary angiomatosis: Kaposi Sarcoma

Bacillary Angiomatosis



A life-threatening but curable infection that causes an eruption of purple lesions on or under the skin that resemble Kaposi's sarcoma. The infection, which occurs almost exclusively in patients with AIDS, can be a complication of cat-scratch disease.


Bacillary angiomatosis is a re-emerging bacterial infection that is identical or closely related to one which commonly afflicted thousands of soldiers during World War I. Today, the disease, caused by two versions of the same bacteria, is linked to homeless AIDS patients and to those afflicted with cat-scratch disease.
The infection is rarely seen today in patients who don't have HIV. According to the U.S. Centers for Disease Control and Prevention (CDC), an HIV patient diagnosed with bacillary angiomatosis is considered to have progressed to full-blown AIDS.

Causes and symptoms

Scientists have recently isolated two varieties of the Bartonella bacteria as the cause of bacillary angiomatosis: Bartonella (formerly Rochalimaea quintana) and B. henselae (cause of cat-scratch disease).
B. quintana infection is known popularly as trench fever, and is the infection associated with body lice that sickened European troops during World War I. Lice carry the bacteria, and can transmit the infection to humans. The incidence of trench fever was believed to have faded away with the end of World War I. It was not diagnosed in the United States until 1992, when 10 cases were reported among homeless Seattle men.
The related bacteria B. henselae was first identified several years ago as the cause of cat-scratch fever. It also can lead to bacillary angiomatosis in AIDS patients. Bacillary angiomatosis caused by this bacteria is transmitted to AIDS patients from cat fleas.
These two different types of bacteria both cause bacillary angiomatosis, a disease which is characterized by wildly proliferating blood vessels that form tumor-like masses in the skin and organs. The nodules that appear in bacillary angiomatosis are firm and don't turn white when pressed. The lesions can occur anywhere on the body, in numbers ranging from one to 100. They are rarely found on palms of the hands, soles of the feet, or in the mouth. As the number of lesions increase, the patient may develop a high fever, sweats, chills, poor appetite, vomiting, and weight loss. If untreated, the infection may be fatal.

Key terms

Cat-scratch disease — An infectious disease caused by bacteria transmitted by the common cat flea that causes a self-limiting, mild infection in healthy people.
Kaposi's sarcoma — A malignant condition that begins as soft brown or purple lesions on the skin that occurs most often in men with AIDS.
In addition to the basic disease process, the two different types of bacteria cause some slightly different symptoms. Patients infected with B. henselae also experience blood-filled cysts within the liver and abnormal liver function, whereas B. quintana patients may have tumor growths in the bone.


This life-threatening but curable infection is often misdiagnosed, because it may be mistaken for other conditions (such as Kaposi's sarcoma). A blood test developed in 1992 by the CDC detects antibodies to the bacteria. It can be confirmed by reviewing symptoms, history and negative tests for other diseases that cause swollen lymph glands. It isn't necessary to biopsy a small sample of the lymph node unless there is a question of cancer of the lymph node or some other disease.


Recent research indicates that antibiotics used to treat other HIV opportunistic infections can both prevent and treat bacillary angiomatosis. Treatment is usually given until the lesions disappear, which typically takes three or four weeks. A severely affected lymph node or blister may have to be drained, and a heating pad may help swollen, tender lymph glands. Acetaminophen (Tylenol) may relieve pain, aches, and fever over 101 °F (38.3 °C).


In most cases, prompt antibiotic treatment in patients with AIDS cured the infection caused by either variety of the bacteria, and patients may resume normal life. Early diagnosis is crucial to a cure.


Studies suggest that antibiotics may prevent the disease. Patients also should be sure to treat cats for fleas.



Koehler, J. E. "Zoonoses: Cats, Fleas and Bacteria." Journal of the American Medical Association 271 (1994): 531-535.
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.

bac·il·la·ry an·gi·o·ma·to·sis

1. an infection of immunocompromised patients by a newly recognized bacterium, Bartonella henselae, characterized by fever, granulomatous cutaneous nodules, and peliosis hepatis in some cases. Skin biopsy shows vascular proliferation and infiltration of vessel walls by neutrophils and clumps of organisms seen with Warthin-Starry silver staining.
2. infectious disease characterized by fever and granulomatous cutaneous lesions. There are two forms. In one, associated with Bartonella henselae, cat bites and scratches are predisposing; lymph nodes and viscera may be involved, and bacillary peliosis of liver and spleen can occur. A separate form, associated with B. quintana, is linked with conditions of poor hygiene (louse infestation, poverty, poor or no housing); subcutaneous and bone lesions are more predominant.
Farlex Partner Medical Dictionary © Farlex 2012

bacillary angiomatosis

A distinct vascular proliferative disorder of the skin and lymph nodes seen in HIV-positive subjects.
Rochalimaea quintana is the most common cause; R henselae is less common, but may also cause bacteraemia in immunocompetent hosts, as well as bacillary peliosis hepatis and splenitis.
Clinical findings
Erythematous papules and nodules, fever, bacteraemia.
Kaposi sarcoma.

Erythromycin, other antibiotics.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.

bacillary angiomatosis

Epithelioid angiomatosis Infectious disease A distinct vascular proliferative disorder of the skin and lymph nodes seen in HIV-positive subjects Etiology.Rochalimaea quintana is the most common cause of BA; R henselae is less common, but may also cause bacteremia, as well as bacillary peliosis hepatis, and splenitis Clinical Erythematous papules and nodules, fever, bacteremia Treatment Erythromycin, other antibiotics. See AIDS, Peliosis hepatitis.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

bac·il·la·ry an·gi·o·ma·to·sis

(bas'i-lar-ē an'jē-ō-mă-tō'sis)
An infection of immunocompromised patients by the rickettsial species Bartonella henselae, characterized by fever and granulomatous cutaneous nodules, and peliosis hepatis in some cases. Skin biopsy shows vascular proliferation and infiltration of vessel walls by neutrophils and clumps of organisms seen with Warthin-Starry silver staining.
Medical Dictionary for the Health Professions and Nursing © Farlex 2012
References in periodicals archive ?
The clinical spectrum of bacillary angiomatosis. Br J Dermatol 1992; 126: 535-41.
Immunodeficient patients may manifest infection as cutaneous bacillary angiomatosis [14], with cutaneous or subcutaneous vascular tumors which may be painful.
It can be a factor in endocarditis and may result in bacillary angiomatosis in those coinfected with HIV.
The most important clinical mimic is bacillary angiomatosis (BA), which can present as multiple, red, vascular skin lesions and also involve visceral organs.
Macroscopically, EH should be differentiated from Kimuras, disease, salivary gland tumour, squamous cell carcinoma, lymphoma, and pyogenic granuloma and histologically these are differentiated from bacillary angiomatosis, epithelioid angiosarcoma, epithelioid neurofibroma, epithelioid schwannoma, epithelioid fibrosarcoma, Kimuras disease, and epithelioid hemangioendothelioma [3].
Lesions that may potentially be confused with nodular KS include bacillary angiomatosis, other vascular tumors (eg, spindle cell hemangioma and Kaposiform hemangioendothelioma), fibrohistiocytic tumors (eg, cellular, angiomatoid, and atypical variants of fibrous histiocytoma, and dermatofibrosarcoma protuberans), resolving dermal fasciitis, spindle cell melanoma, and several other spindle cell mesenchymal neoplasms (eg, cutaneous leiomyosarcoma).
Rochalimaea henselae causes bacillary angiomatosis and peliosis hepatis.
PG-like KS may very much resemble bacillary angiomatosis [54].
As a side note, the authors say that bacillary angiomatosis ("cat scratch disease") infects humans when flea excrement containing the bug Bartonella henselae gets under the skin along with the cat scratch.
When human immunodeficiency virus (HIV) became more prevalent in the 1990s, a newly recognized disease called bacillary angiomatosis was recognized.
Using a flea treatment is especially recommended for cats who live with immuno-compromised patients, such as HIV-infected patients who are susceptible to developing more severe manifestations of the infection, including bacillary angiomatosis.