Bacillary angiomatosis

"cat scratch disease"

This is part of a series on Opportunistic Infections ("OIs"). Please note that --

This Page Is Just A Starting Point: ÆGIS is a great place for you to find overview information about HIV and opportunistic infections, but it is not a substitute for getting medical advice from a doctor who specializes in treating HIV.
Finding The Latest Information: Advances in treating opportunistic infections can happen at any time, so the material on this page may be outdated. Some links in the see also section at the bottom of this page are actually special database links. They may contain information published after this page was written.

CD4 Danger Zone

CD4+ counts less than 500 cells/mm.

NOTE:

If you are undergoing treatment that has increased your CD4+ levels, see the important note on Naive T-Cells. There is some evidence that you should use the lowest CD4+ level you ever had when considering your risk for some opportunistic infections.

Description

Bacillary angiomatosis is an infection caused by bacteria from the genus Rochalimaea.that is characterized by the eruption of cutaneous and subcutaneous nodules. As the number of lesions increases, patients may develop fever, sweats, chills, poor appetite, vomiting and weight loss. If untreated, patients die from complications of the disease. The diagnosis rests on clinical parameters supported by histologic confirmation. Treatment with oral antibiotics for at least 2 weeks is highly effective. [Miguel R. Sánchez, M.D.]

This infection can cause blood vessels to grow out of control and form tumor-like masses in skin, bone, liver and other organs. It is a life-threatening, but curable bacterial infection that is often missed because it may be mistaken for other conditions such as KS. Although bacillary angiomatosis is rare in people with intact immune systems, it can be fatal in people with HIV infection. Antibiotic treatment of 4 HIV+ people with bacillary angiomatosis completely cured them of the bacterial infection. All 4 people, who were very sick with the illness, were able to resume normal living. This condition is being seen in more people with HIV.[The Network, 1994]

Bacillary angiomatosis is ... rarely seen in non HIV infected individuals. It appears as papules or nodules that are usually purplish to bright red and often resemble Kaposi's sarcoma. The lesions are firm and non blanching (they do not turn white when you push on them). They can occur anywhere on the body in numbers ranging from one to hundreds but are rarely seen on the palms, soles, or in the mouth. High fever is usually present and the infection can spread to the bone, bone marrow, spleen, lymph nodes and liver. It can be easily treated with antibiotics such as erythromycin and doxycycline. Treatment is given until the lesions resolve, usually in 3 to 4 weeks. In some people, the lesions can regress without treatment. [Project Inform, 1994]