Background: No data were available on the epidemiological and clinical characteristics of bacillary angiomatosis (BA) in Germany. Objective: To determine epidemiological and clinical data on HIV-associated BA. Methods: A chart review of all BA cases between 1990 and 1998 was performed in 23 German AIDS treatment units. Results: A total of 21 cases of BA was diagnosed. During this period, the participating HIV centers treated about 17,000 HIV-infected patients. As a result, a BA prevalence of 1.2 cases/1,000 patients can be assumed. 19 BA were localized in the skin; in 5 cases bones and in 4 cases the liver were involved. Out of 20 patients who received antibiotic therapy, 13 had complete remission. The median time of duration up to complete remission was 32 days (9–82). During the follow-up of the 20 patients, 7 relapses were observed. Conclusion: BA is a rare HIV-associated disease with a prevalence of 1,2 cases/1,000 patients in the presented study.

Bartonella quintana was grown from a lysis-centrifugation blood culture of an HIV-positive man who presented with lesions of bacillary angiomatosis in skin and bones. The isolate was identified by sodium dodecylsulfate-polyacrylamide gel electrophoresis, 16S rRNA gene sequencing, and amplification of the enterobacterial repetitive intergenic consensus sequences.

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We report a 34-year-old homosexual man who developed a maculopapular, non-itchy exanthema mainly on the trunk in addition to fever up to 39.8 degrees C, general malaise, arthralgias, generalized enlargement of the lymph nodes, watery diarrhoea and weight loss. The patient was in an acute phase of the HIV infection according to standards of WHO and CDC (i.e. acute infection with duration from 3 days to 3 weeks with occasional mononucleosis-like symptoms and positive antibody tests). We documented the seroconversion from HIV-negativity to HIV-positivity 15 days after the onset of the acute illness, concomitant with the resolution of the clinical symptoms. Haematological changes were monitored during the conversion. The infection with HIV-1 was shown by the reduction of T4 helper cells (262/microliters) and the inversion of the CD4:CD8 ratio (< 0.5 during seroconversion). The patient also developed generalized candidiasis owing to the acute immunodeficiency.

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