Bacillary angiomatosis

Last revised by Bálint Botz on 22 May 2020

Bacillary angiomatosis is an infective complication in those with the acquired immunodeficiency syndrome (AIDS) 3. Amongst other widespread multi-organ manifestations, the infection causes skin lesions which can be similar to those of Kaposi sarcoma.

Characterized by a non-neoplastic vascular proliferation related to infection.

Typical causative organisms include 2:

  • Bartonella henselae: causes cat-scratch disease in non-immunocompromised patients
  • Bartonella quintana

Lesions typically demonstrate characteristic pleomorphic bacillary organisms following the Warthin-Starry stain.

It may be better outlined according to location rather than modality:

  • lung nodules
  • mediastinal adenopathy
  • peripheral adenopathy
  • pleural effusions
  • ascites
  • abdominal adenopathy
  • soft-tissue masses
  • low-attenuating lesions in the liver +/- spleen 5,6
    • lesions often show enhancement with contrast

Often treated with erythromycin.

It was originally described in 1983 by Stoler et al. 1.

  • Kaposi sarcoma: can have similar cutaneous manifestations, but no osteolytic bone lesions

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