Bacillary angiomatosis: description of 13 cases reported in five reference centers for AIDS treatment in Rio de Janeiro, Brazil

Abstract

The aim of this case series was to describe the clinical, laboratory and epidemiological characteristics and the presentation of bacillary angiomatosis cases (and/or parenchymal bacillary peliosis) that were identified in five public hospitals of Rio de Janeiro state between 1990 and 1997; these cases were compared with those previously described in the medical literature. Thirteen case-patients were enrolled in the study; the median age was 39 years and all patients were male. All patients were human immunodeficiency virus type 1 (HIV-1) infected and they had previous or concomitant HIV-associated opportunistic infections or malignancies diagnosed at the time bacillary angiomatosis was diagnosed. Median T4 helper lymphocyte counts of patients was 96 cells per mm(3). Cutaneous involvement was the most common clinical manifestation of bacillary angiomatosis in this study. Clinical remission following appropriate treatment was more common in our case series than that reported in the medical literature, while the incidence of relapse was similar. The frequency of bacillary angiomatosis in HIV patients calculated from two of the hospitals included in our study was 1.42 cases per 1000 patients, similar to the frequencies reported in the medical literature. Bacillary angiomatosis is an unusual opportunistic pathogen in our setting.

Bacillary angiomatosis in HIV-positive patient from Northeastern Brazil: a case report

“…Bacillary angiomatosis affects most commonly the HIV-positive patients when compared with other types of immunodeficiency; the majority is seen 1, 3 in advanced stage of AIDS and CD4 count less than 200 cells/mm 3 . The patient presented here had a CD4 count of 440 cells/mm 3 , which is not commonly observed; therefore, other factors must have contributed to the development of this disease, like poor living conditions.…”

“…A pedunculated tumor in the perineal region with irregular surface and erythematous base was observed as well as numerous small angiomatous papules all over the body. He also had anemia and CD4 count of 15 cells/mm 3 .…”

“…It has a worldwide distribution, and based on a recent review, Bartonella largely circulates among the Brazilian population 2 , with a prevalence of 1.42/1,000 AIDS patients in Rio de Janeiro, Brazil 3 . Commonly described in AIDS patient, BA has rarely been reported in immunocompetent individuals 4 or non-HIV-infected immunosupressed patients 5 .…”

“…Bacillary angiomatosis denomination comes from the vascular proliferative histopathology of skin, lymph nodes, viscera, and bones 3 . Therefore, the organisms can be identified in the tissues by means of silver staining when more advanced methods are unavailable 3 .…”

“…Therefore, the organisms can be identified in the tissues by means of silver staining when more advanced methods are unavailable 3 .…”