Clinical and pathological features of bacillary peliosis hepatis in association with human immunodeficiency virus infection

Article Abstract:

The unusual occurrence of a pair of conditions in two patients infected with HIV (human immunodeficiency virus, associated with AIDS), and of one of the conditions in an additional six HIV-infected patients, is the subject of this report. Peliosis hepatis, present in all eight patients, is a potentially fatal condition in which blood-filled spaces appear in the liver; it has been noted in patients with advanced cancer, tuberculosis, or those who have used anabolic steroids and certain other drugs. Two patients also had cutaneous bacillary angiomatosis, a disease characterized by the proliferation of blood vessels in the skin and progressive nodularity. The patients had fever, abdominal pain, and gastrointestinal symptoms, with weight loss and loss of appetite. Their livers were enlarged, and most had enlarged spleens and lymph nodes, as well. Liver biopsies were performed in four patients, and the results are presented. Tissue from four non-HIV-infected patients with peliosis hepatis was also studied. Pathological features unique to the HIV patients were identified. Microbiologic evaluation identified a bacillus similar to that found in the lesions of the patients with cutaneous bacillary angiomatosis. It could not be grown in culture, however. Two patients responded to treatment with antibiotics; for various reasons, antibiotic effectiveness could not be evaluated for all the patients. A discussion is presented of diagnostic and microbiologic features of peliosis hepatis and cutaneous bacillary angiomatosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Bacillary angiomatosis

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Isolation of Rochalimaea species from cutaneous and osseous lesions of bacillary angiomatosis

Article Abstract:

Bacillary angiomatosis can be diagnosed by isolating the bacteria Rochalimaea quintana or Rochalimaea henselae from skin lesions or blood. Bacillary angiomatosis is a recently recognized disease found mostly in HIV patients. It is marked by blood vessel lesions on the skin and occasionally on bone. Previous attempts to isolate the bacteria that cause bacillary angiomatosis have not been successful. Using tissue and blood samples from four HIV patients, Rochalimaea quintana was isolated from skin lesions of three patients, from skin lesions and blood in two patients and from bone in one patient. Rochalimaea henselae was isolated from a skin lesion in one patient. These findings suggest isolating Rochalimaea species can be used to diagnose bacillary angiomatosis.

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Molecular epidemiology of Bartonella infections in patients with bacillary angiomatosis-peliosis

Article Abstract:

The two primary species of the bacterium Bartonella appear to affect different body systems and have different risk factors. Bartonella (B.) infection was first discovered in AIDS patients and causes angiomatosis and peliosis. Angiomatosis tends to affect skin, bone and other organs whereas peliosis primarily affects the liver and spleen. A study of 49 patients with either of these conditions found that about half were infected with B. henselae and half with B. quintana. Peliosis was strongly linked to B. henselae and angiomatosis was linked to B. quintana. Cat exposure was linked to B. henselae infection whereas lice exposure was linked to B. quintana.

Health aspects, Risk factors, Bacterial infections, Bartonella

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