What is bacillary angiomatosis?
Bacillary angiomatosis is a life-threatening infection caused by Bartonella henselae
(transmitted to humans by the scratches or saliva of infected cats) or Bartonella
quintana (transmitted by the human body louse) that presents most often in
immunosuppressed patients (HIV, organ transplantation, leukaemia, chemotherapy).
Skin, mucosal surfaces, bones, and viscera may be involved by tumour- like vascular
masses.
What should I look for?
• Red or purplish cutaneous and/or subcutaneous vascular papules and tender nodules,
ranging in diameter from a few mm to 10cm. The presentation may simulate Kaposi
sarcoma (KS), but lesions are less common on soles or in the mouth than in KS.
• Fever, nausea, vomiting, headache, malaise, and weight loss.
• Tender lymphadenopathy which may suppurate.
• Focal bone pain.
What should I do?
• Biopsy the skin, and take blood for cultures.
• Treat promptly with erythromycin 500mg qds (or doxycycline) for up to 4 months in
immunocompromised patients.
• provide analgesia for pain and fever.