Epithelioid angiomatosis secondary to disseminated cat scratch disease involving bone marrow and skin in a patient with acquired immune deficiency syndrome: a case report

Article Abstract:

Angiomatous lesions are a type of skin tumor, usually benign, that consist of blood or lymph vessels, and may be caused by the cat scratch bacillus, a type of bacteria. These skin lesions may occur in patients with acquired immunodeficiency syndrome (AIDS) and may be confused with Kaposi's sarcoma, which is characterized by multiple areas of cell proliferation or overgrowth on the skin and is associated with the weakened immune system of AIDS patients. The cat scratch bacillus is one of several infections commonly associated with AIDS. This bacteria may enter through the skin, eyes, or mucous membranes lining body cavities, such as the mouth or nose, and may cause swelling of the lymph nodes. In one to two percent of patients without AIDS, cat scratch infection may become disseminated or widespread. A case is described of a 40-year-old man with AIDS, who developed an angiomatous lesion on the skin of his left hand as a result of cat scratch disease. The infection spread to other body sites including the bone marrow, blood, lymph nodes, liver, and spleen. The patient had an enlarged lymph node in the armpit area, which was the only evidence of lymphadenopathy, or disease of the lymph nodes, and platelet antibodies, specialized proteins that specifically bind to platelets, blood cells involved in blood clotting. Abnormalities of the skin, blood, liver, and spleen improved after antibiotic treatment with piperacillin, gentamicin, and erythromycin. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Skin, AIDS (Disease), Angioma

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Inflammatory pseudotumor of intra-abdominal lymph nodes manifesting as recurrent fever of unknown origin: a case report

Article Abstract:

Fever is a general symptom of many diseases. Fever lasting a long time or recurring often can be caused by a number of problems, including cancer. A recently discovered abnormality of the lymph nodes, inflammatory pseudotumor (IPT), has been described. It is similar in symptoms to cancerous tumors of the lymph nodes, including persistent fever, but it is not malignant and does not require the aggressive therapy needed for cancer. It is thus important that the two diseases not be confused. The case of a 27-year-old man complaining of recurrent fever and weight loss is discussed. He was examined for human immunodeficiency virus (HIV) infection as well as a number of other possible causes, all with negative results. Computerized tomographic (CT) scans were performed on his chest and abdominal areas and they showed enlargement of the spleen and some lymph nodes. Lymph node cancer was suspected and biopsies were performed. Careful examination of the biopsied tissues found the patient was suffering from IPT, not lymph node cancer. His spleen was removed, but no other treatment was given. He has had no further symptoms in the three years since this episode. The case illustrates that IPT should be considered a possible cause of continuous or recurrent fevers when other causes have been ruled out, and examination of lymph node biopsy should be done carefully so that cancer is not misdiagnosed yet unneeded therapy is not given. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Fever, Lymphadenopathy

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Visceral bacillary epithelioid angiomatosis: possible manifestations of disseminated cat scratch disease in the immunocompromised host: a report of two cases

Article Abstract:

Bacillary epithelioid angiomatosis (BEA) is a disorder of the skin blood vessels and may occur in patients infected with human immunodeficiency virus (HIV). Although it was first thought to be a cancer-like process, the lesions, characterized by overgrowth of blood vessels, were later identified as a reaction to infection with a cat scratch bacillus or similar microorganism. No lesions other than those affecting the bone and skin have been reported previously. Two cases are described of patients infected with cat scratch-like bacilli, who had BEA involving internal organs, including the liver, bone marrow, and spleen. The first case is of a patient with HIV infection and BEA involving the liver and bone marrow. This patient developed rapidly progressing liver failure, brain disease, disorders of blood coagulation, anemia, and decreased numbers of platelets, cells involved in blood clotting. The second case is a heart transplant recipient, who developed a fever due to BEA involving the liver and spleen. This second case shows that BEA can affect persons not infected with HIV. These two cases are the first reports of BEA involving internal organs and associated with infection by cat scratch-like microorganisms. (Consumer Summary produced by Reliance Medical Information, Inc.)

HIV infection, HIV infections, Lymphadenitis, Angiomatosis

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