Bacillary Angiomatosis in HIV-Infected Patients – An Epidemiological and Clinical Study

Plettenberg, Andreas; Lorenzen, Thore; Burtsche, B. T.; Rasokat, H.; Kaliebe, T.; Albrecht, Helmut; Mertenskötter, T.; Bogner, Johannes R.; Stoehr, Albrecht; Schöfer, Helmut

doi:10.1159/000051547

Cited by 66 publications

(36 citation statements)

References 19 publications

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“…Both B. quintana and B. henselae are further able to elicit bacillary angiomatosis, i.e., the outgrowth of multiple vasoproliferative tumors, as a common complication of infection, primarily but not exclusively in immunocompromised individuals such as AIDS patients. While these lesions are most often found on the skin, bacillary angiomatosis or related conditions may also affect the liver ("bacillary peliosis"), spleen, bone marrow, eyes, or other parts of the body (304,339). The dissemination of Bartonella infections is a complication observed mostly in highly immunocompromised patients, but it can also occur in apparently immunocompetent individuals.…”

Section: Clinical Aspectsmentioning

confidence: 99%

Intruders below the Radar: Molecular Pathogenesis of Bartonella spp

2012

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SUMMARY Bartonella spp. are facultative intracellular pathogens that employ a unique stealth infection strategy comprising immune evasion and modulation, intimate interaction with nucleated cells, and intraerythrocytic persistence. Infections with Bartonella are ubiquitous among mammals, and many species can infect humans either as their natural host or incidentally as zoonotic pathogens. Upon inoculation into a naive host, the bartonellae first colonize a primary niche that is widely accepted to involve the manipulation of nucleated host cells, e.g., in the microvasculature. Consistently, in vitro research showed that Bartonella harbors an ample arsenal of virulence factors to modulate the response of such cells, gain entrance, and establish an intracellular niche. Subsequently, the bacteria are seeded into the bloodstream where they invade erythrocytes and give rise to a typically asymptomatic intraerythrocytic bacteremia. While this course of infection is characteristic for natural hosts, zoonotic infections or the infection of immunocompromised patients may alter the path of Bartonella and result in considerable morbidity. In this review we compile current knowledge on the molecular processes underlying both the infection strategy and pathogenesis of Bartonella and discuss their connection to the clinical presentation of human patients, which ranges from minor complaints to life-threatening disease.

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Section: Clinical Aspectsmentioning

confidence: 99%

Intruders below the Radar: Molecular Pathogenesis of Bartonella spp

2012

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“…1 Gazineo et al 4 observed the median of TCD4 + cells equal to 85.8 (± 73.9) cells/mm 3 . Plettenberg et al 6 and Mohle-Boetani et al. 7 found median of 30 cells/mm 3 and 21 cells/mm 3 , respectively.…”

Section: Discussionmentioning

confidence: 95%

“…4 In Germany, Plettenberg et al reported 1.2 cases per 1,000 HIV-positive patients between 1990 and 1996. 6 …”

Section: Discussionmentioning

confidence: 99%

Bacillary angiomatosis with bone invasion

Diniz

Medeiros

Landeiro

et al. 2016

An. Bras. Dermatol.

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Bacillary angiomatosis is an infection determined by Bartonella henselae and B. quintana, rare and prevalent in patients with acquired immunodeficiency syndrome. We describe a case of a patient with AIDS and TCD4+ cells equal to 9/mm3, showing reddish-violet papular and nodular lesions, disseminated over the skin, most on the back of the right hand and third finger, with osteolysis of the distal phalanx observed by radiography. The findings of vascular proliferation with presence of bacilli, on the histopathological examination of the skin and bone lesions, led to the diagnosis of bacillary angiomatosis. Corroborating the literature, in the present case the infection affected a young man (29 years old) with advanced immunosuppression and clinical and histological lesions compatible with the diagnosis.

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“…In HIV, it is considered to be a late-stage infection, and although seroprevalence can be high, 137 clinical prevalence rates have been reported to be low at 1.2 cases per 1000 patients. 138 Bacillary angiomatosis presents with lymphadenopathy and abdominal pain, and manifests as disseminated lesions on the skin, and in the liver and other solid organs. [139][140][141] In the liver, cystic spaces filled with blood (peliosis hepatis) are seen.…”

Section: Bacillary Angiomatosismentioning

confidence: 99%