Bacillary Angiomatosis

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Jordan W. Tappero - One of the best experts on this subject based on the ideXlab platform.

  • Bacillary Angiomatosis or Kaposi's Sarcoma?
    The New England Journal of Medicine, 1997
    Co-Authors: Jordan W. Tappero, Jane E Koehler
    Abstract:

    Figure 1. Bacillary Angiomatosis and Kaposi's sarcoma can be especially difficult to differentiate clinically. In each pair of figures, one shows a Bacillary Angiomatosis lesion (Panels A and B) and one shows a clinically indistinguishable Kaposi's sarcoma lesion (Panels C and D). There are many causes of moist, erosive cutaneous vascular lesions in immunocompromised patients. A tissue biopsy is required for diagnosis. Other bacterial and fungal infections, as well as pyogenic granuloma, may also have similar clinical appearances. On routine staining with hematoxylin and eosin, Bacillary Angiomatosis lesions show acute neutrophilic inflammation and capillary proliferation. Kaposi's sarcoma lesions show slit-like . . .

  • molecular epidemiology of bartonella infections in patients with Bacillary Angiomatosis peliosis
    The New England Journal of Medicine, 1997
    Co-Authors: Jane E Koehler, Philip E. Leboit, Margot J. Whitfeld, Melissa A Sanchez, Claudia S Garrido, Frederick M Chen, Timothy G Berger, Maria C Rodriguezbarradas, Jordan W. Tappero
    Abstract:

    Background Bacillary Angiomatosis and Bacillary peliosis are vascular proliferative manifestations of infection with species of the genus bartonella that occur predominantly in patients infected with the human immunodeficiency virus. Two species, Bartonella henselae and B. quintana, have been associated with Bacillary Angiomatosis, but culture and speciation are difficult, and there has been little systematic evaluation of the species-specific disease characteristics. We studied 49 patients seen over eight years who were infected with bartonella species identified by molecular techniques and who had clinical lesions consistent with Bacillary Angiomatosis–peliosis. Methods In this case–control study, a standardized questionnaire about exposures was administered to patients with Bacillary Angiomatosis–peliosis and to 96 matched controls. The infecting bartonella species were determined by molecular techniques. Results Of the 49 patients with Bacillary Angiomatosis–peliosis, 26 (53 percent) were infected wit...

  • unraveling mysteries associated with cat scratch disease Bacillary Angiomatosis and related syndromes
    Emerging Infectious Diseases, 1995
    Co-Authors: Russell L Regnery, Jordan W. Tappero
    Abstract:

    The search for the infectious agents responsible for cat-scratch disease, Bacillary Angiomatosis, and related syndromes has a long and often circuitous history. Recognition of the etiologic agents and a new understanding of the fundamental features of the epidemiology and natural history of modern day Bartonella (formerly Rochalimaea)-associated diseases culminate a multipartite story that combines clinical medicine, traditional microbiology, and novel technological approaches to solve a long-standing enigma.

  • Bacillary Angiomatosis and Bacillary splenitis in immunocompetent adults
    Annals of Internal Medicine, 1993
    Co-Authors: Jordan W. Tappero, Jane E Koehler, Clay J. Cockerell, Timothy G Berger, Tzonghae Lee, Michael P Busch, Daniel P Stites, Janet C Mohleboetani, Arthur L Reingold, Philip E. Leboit
    Abstract:

    Bacillary Angiomatosis and Bacillary peliosis have been described in patients with human immunodeficiency virus (HIV) infection and drug-induced immunosuppression. Patients with these vascular lesi...

  • the epidemiology of Bacillary Angiomatosis and Bacillary peliosis
    JAMA, 1993
    Co-Authors: Jordan W. Tappero, Jane E Koehler, Philip E. Leboit, Timothy G Berger, Janet C Mohleboetani, B Swaminathan, Laura L Smith, Jay D Wenger, Robert W Pinner, Carol A Kemper
    Abstract:

    Objective.\p=m-\Todetermine environmental risk factors for Bacillary Angiomatosis\x=req-\ Bacillary peliosis (BAP), and to confirm infection with Rochalimaea species. Design.\p=m-\Case-controlstudy. Setting.\p=m-\Community and university hospitals and clinics. Patients.\p=m-\Case patients (N=48) had biopsy-confirmed BAP. Controls (N=94) were matched to patients by institution and by human immunodeficiency virus (HIV) serological status. Main Outcome Measures.\p=m-\Clinicalinformation was obtained from medical records. Subjects were queried about environmental exposures. Univariate odds ratios (ORs) with 95% confidence intervals (Cls) were determined. Bivariate analyses were performed on variables associated with disease by univariate analysis. DNA from 22 available case-patient tissues and from 22 control tissues was amplified with the polymerase chain reaction (PCR) using primers designed to detect Rochalimaea species. Results.\p=m-\Weidentified five HIV-negative, immunocompetent case patients; one HIV-negative, immunodeficient case patient; and 42 HIV-positive case patients. There were no significant differences between case patients and controls by race, sex, age, or risk factors for HIV infection. Owning a cat (OR, 2.8; CI, 1.4 to 5.8) and history of a recent cat lick (OR, 1.95; CI, 1.0 to 3.8), cat scratch (OR, 3.7; CI, 1.7 to 8.0), or cat bite (OR, 3.9; CI, 1.8 to 8.9) were associated with disease in the univariate analysis. In bivariate analyses, only the variables representing traumatic contact with a cat (bite or scratch) remained associated with disease. No other environmental exposure was associated with disease. The PCR amplified a DNA fragment of the size expected for Rochalimaea species in all 22 case-patient tissue specimens. Conclusions.\p=m-\Thesedata suggest that BAP is a new zoonosis associated with both traumatic exposure to cats and infection with Rochalimaea species or a closely related organism.

Jane E Koehler - One of the best experts on this subject based on the ideXlab platform.

  • absence of kaposi s sarcoma associated herpesvirus dna in Bacillary Angiomatosis peliosis lesions
    The Journal of Infectious Diseases, 1999
    Co-Authors: David A. Relman, Timothy G Berger, David N Fredricks, Kristine E Yoder, Ginat Mirowski, Jane E Koehler
    Abstract:

    Bartonella henselae and B. quintana induce an unusual vascular proliferative tissue response known as Bacillary Angiomatosis (BA) and Bacillary peliosis (BP) in some human hosts. The mechanisms of Bartonella-associated vascular proliferation remain unclear. Although host factors probably play a role, microbial coinfection has not been ruled out. Because of the vascular proliferative characteristics noted in both Kaposi's sarcoma (KS) and BA and occasional colocalization of KS and BA, the possibility was explored that KS-associated herpesvirus (KSHV) might be associated with BA lesions. Tissues with BA and positive and negative control tissues were tested for the presence of KSHV DNA by a sensitive polymerase chain reaction assay. Only 1 of 10 BA tissues, a splenic biopsy, was positive in this assay; this tissue was from a patient with concomitant KS of the skin. Thus, KSHV is probably not involved in the vascular proliferative response seen in BA-BP.

  • Bacillary Angiomatosis or Kaposi's Sarcoma?
    The New England Journal of Medicine, 1997
    Co-Authors: Jordan W. Tappero, Jane E Koehler
    Abstract:

    Figure 1. Bacillary Angiomatosis and Kaposi's sarcoma can be especially difficult to differentiate clinically. In each pair of figures, one shows a Bacillary Angiomatosis lesion (Panels A and B) and one shows a clinically indistinguishable Kaposi's sarcoma lesion (Panels C and D). There are many causes of moist, erosive cutaneous vascular lesions in immunocompromised patients. A tissue biopsy is required for diagnosis. Other bacterial and fungal infections, as well as pyogenic granuloma, may also have similar clinical appearances. On routine staining with hematoxylin and eosin, Bacillary Angiomatosis lesions show acute neutrophilic inflammation and capillary proliferation. Kaposi's sarcoma lesions show slit-like . . .

  • molecular epidemiology of bartonella infections in patients with Bacillary Angiomatosis peliosis
    The New England Journal of Medicine, 1997
    Co-Authors: Jane E Koehler, Philip E. Leboit, Margot J. Whitfeld, Melissa A Sanchez, Claudia S Garrido, Frederick M Chen, Timothy G Berger, Maria C Rodriguezbarradas, Jordan W. Tappero
    Abstract:

    Background Bacillary Angiomatosis and Bacillary peliosis are vascular proliferative manifestations of infection with species of the genus bartonella that occur predominantly in patients infected with the human immunodeficiency virus. Two species, Bartonella henselae and B. quintana, have been associated with Bacillary Angiomatosis, but culture and speciation are difficult, and there has been little systematic evaluation of the species-specific disease characteristics. We studied 49 patients seen over eight years who were infected with bartonella species identified by molecular techniques and who had clinical lesions consistent with Bacillary Angiomatosis–peliosis. Methods In this case–control study, a standardized questionnaire about exposures was administered to patients with Bacillary Angiomatosis–peliosis and to 96 matched controls. The infecting bartonella species were determined by molecular techniques. Results Of the 49 patients with Bacillary Angiomatosis–peliosis, 26 (53 percent) were infected wit...

  • Bacillary Angiomatosis associated with myositis in a patient infected with human immunodeficiency virus
    Clinical Infectious Diseases, 1997
    Co-Authors: Margot J. Whitfeld, Jane E Koehler, Sassan Kaveh, Paul S Mead, Timothy G Berger
    Abstract:

    A man with AIDS presented with a deep soft-tissue mass involving the right thigh. Biopsy of a skin lesion on the back and culture of a specimen from this lesion showed Bacillary Angiomatosis due to Bartonella (formerly Rochalimaea) quintana. Magnetic resonance imaging revealed a large heterogeneous mass involving the vastus medialis and intermedius muscles. Therapy with erythromycin caused rapid resolution of both the cutaneous lesion and the muscle lesion. Bartonella infection is proposed as an additional cause of bacterial myositis and expands the spectrum of presentation of Bacillary Angiomatosis.

  • Bacillary Angiomatosis of the cervix and vulva in a patient with AIDS.
    Obstetrics & Gynecology, 1996
    Co-Authors: Steven R. Long, Jane E Koehler, Margot J. Whitfeld, Carol A. Eades, Abner P. Korn, Charles Zaloudek
    Abstract:

    Background Bacillary Angiomatosis is a clinicopathologic entity that most often is identified in the skin of patients with AIDS. This report presents an example of Bacillary Angiomatosis of the female genital tract. Case Bacillary Angiomatosis presented as red-purple nodules of the vulva and cervix in a 32-year-old woman with AIDS. Histologic examination revealed the lobular epithelioid vascular proliferation and hazy clumps of bacteria that characterize Bacillary Angiomatosis. The diagnosis was confirmed on Warthin-Starry-stained tissue and by blood cultures, which were positive for Bartonella ( Rochalimaea ) henselae . Conclusion Accurate diagnosis of this infection is important because 1) Bacillary Angiomatosis is commonly mistaken for Kaposi sarcoma, 2) it is effectively treated with inexpensive antibiotics, and 3) undiagnosed and/or untreated Bacillary Angiomatosis may lead to overwhelming disseminated infection and death.

Timothy G Berger - One of the best experts on this subject based on the ideXlab platform.

  • absence of kaposi s sarcoma associated herpesvirus dna in Bacillary Angiomatosis peliosis lesions
    The Journal of Infectious Diseases, 1999
    Co-Authors: David A. Relman, Timothy G Berger, David N Fredricks, Kristine E Yoder, Ginat Mirowski, Jane E Koehler
    Abstract:

    Bartonella henselae and B. quintana induce an unusual vascular proliferative tissue response known as Bacillary Angiomatosis (BA) and Bacillary peliosis (BP) in some human hosts. The mechanisms of Bartonella-associated vascular proliferation remain unclear. Although host factors probably play a role, microbial coinfection has not been ruled out. Because of the vascular proliferative characteristics noted in both Kaposi's sarcoma (KS) and BA and occasional colocalization of KS and BA, the possibility was explored that KS-associated herpesvirus (KSHV) might be associated with BA lesions. Tissues with BA and positive and negative control tissues were tested for the presence of KSHV DNA by a sensitive polymerase chain reaction assay. Only 1 of 10 BA tissues, a splenic biopsy, was positive in this assay; this tissue was from a patient with concomitant KS of the skin. Thus, KSHV is probably not involved in the vascular proliferative response seen in BA-BP.

  • molecular epidemiology of bartonella infections in patients with Bacillary Angiomatosis peliosis
    The New England Journal of Medicine, 1997
    Co-Authors: Jane E Koehler, Philip E. Leboit, Margot J. Whitfeld, Melissa A Sanchez, Claudia S Garrido, Frederick M Chen, Timothy G Berger, Maria C Rodriguezbarradas, Jordan W. Tappero
    Abstract:

    Background Bacillary Angiomatosis and Bacillary peliosis are vascular proliferative manifestations of infection with species of the genus bartonella that occur predominantly in patients infected with the human immunodeficiency virus. Two species, Bartonella henselae and B. quintana, have been associated with Bacillary Angiomatosis, but culture and speciation are difficult, and there has been little systematic evaluation of the species-specific disease characteristics. We studied 49 patients seen over eight years who were infected with bartonella species identified by molecular techniques and who had clinical lesions consistent with Bacillary Angiomatosis–peliosis. Methods In this case–control study, a standardized questionnaire about exposures was administered to patients with Bacillary Angiomatosis–peliosis and to 96 matched controls. The infecting bartonella species were determined by molecular techniques. Results Of the 49 patients with Bacillary Angiomatosis–peliosis, 26 (53 percent) were infected wit...

  • Bacillary Angiomatosis associated with myositis in a patient infected with human immunodeficiency virus
    Clinical Infectious Diseases, 1997
    Co-Authors: Margot J. Whitfeld, Jane E Koehler, Sassan Kaveh, Paul S Mead, Timothy G Berger
    Abstract:

    A man with AIDS presented with a deep soft-tissue mass involving the right thigh. Biopsy of a skin lesion on the back and culture of a specimen from this lesion showed Bacillary Angiomatosis due to Bartonella (formerly Rochalimaea) quintana. Magnetic resonance imaging revealed a large heterogeneous mass involving the vastus medialis and intermedius muscles. Therapy with erythromycin caused rapid resolution of both the cutaneous lesion and the muscle lesion. Bartonella infection is proposed as an additional cause of bacterial myositis and expands the spectrum of presentation of Bacillary Angiomatosis.

  • Bacillary Angiomatosis and Bacillary splenitis in immunocompetent adults
    Annals of Internal Medicine, 1993
    Co-Authors: Jordan W. Tappero, Jane E Koehler, Clay J. Cockerell, Timothy G Berger, Tzonghae Lee, Michael P Busch, Daniel P Stites, Janet C Mohleboetani, Arthur L Reingold, Philip E. Leboit
    Abstract:

    Bacillary Angiomatosis and Bacillary peliosis have been described in patients with human immunodeficiency virus (HIV) infection and drug-induced immunosuppression. Patients with these vascular lesi...

  • the epidemiology of Bacillary Angiomatosis and Bacillary peliosis
    JAMA, 1993
    Co-Authors: Jordan W. Tappero, Jane E Koehler, Philip E. Leboit, Timothy G Berger, Janet C Mohleboetani, B Swaminathan, Laura L Smith, Jay D Wenger, Robert W Pinner, Carol A Kemper
    Abstract:

    Objective.\p=m-\Todetermine environmental risk factors for Bacillary Angiomatosis\x=req-\ Bacillary peliosis (BAP), and to confirm infection with Rochalimaea species. Design.\p=m-\Case-controlstudy. Setting.\p=m-\Community and university hospitals and clinics. Patients.\p=m-\Case patients (N=48) had biopsy-confirmed BAP. Controls (N=94) were matched to patients by institution and by human immunodeficiency virus (HIV) serological status. Main Outcome Measures.\p=m-\Clinicalinformation was obtained from medical records. Subjects were queried about environmental exposures. Univariate odds ratios (ORs) with 95% confidence intervals (Cls) were determined. Bivariate analyses were performed on variables associated with disease by univariate analysis. DNA from 22 available case-patient tissues and from 22 control tissues was amplified with the polymerase chain reaction (PCR) using primers designed to detect Rochalimaea species. Results.\p=m-\Weidentified five HIV-negative, immunocompetent case patients; one HIV-negative, immunodeficient case patient; and 42 HIV-positive case patients. There were no significant differences between case patients and controls by race, sex, age, or risk factors for HIV infection. Owning a cat (OR, 2.8; CI, 1.4 to 5.8) and history of a recent cat lick (OR, 1.95; CI, 1.0 to 3.8), cat scratch (OR, 3.7; CI, 1.7 to 8.0), or cat bite (OR, 3.9; CI, 1.8 to 8.9) were associated with disease in the univariate analysis. In bivariate analyses, only the variables representing traumatic contact with a cat (bite or scratch) remained associated with disease. No other environmental exposure was associated with disease. The PCR amplified a DNA fragment of the size expected for Rochalimaea species in all 22 case-patient tissue specimens. Conclusions.\p=m-\Thesedata suggest that BAP is a new zoonosis associated with both traumatic exposure to cats and infection with Rochalimaea species or a closely related organism.

Philip E. Leboit - One of the best experts on this subject based on the ideXlab platform.

  • molecular epidemiology of bartonella infections in patients with Bacillary Angiomatosis peliosis
    The New England Journal of Medicine, 1997
    Co-Authors: Jane E Koehler, Philip E. Leboit, Margot J. Whitfeld, Melissa A Sanchez, Claudia S Garrido, Frederick M Chen, Timothy G Berger, Maria C Rodriguezbarradas, Jordan W. Tappero
    Abstract:

    Background Bacillary Angiomatosis and Bacillary peliosis are vascular proliferative manifestations of infection with species of the genus bartonella that occur predominantly in patients infected with the human immunodeficiency virus. Two species, Bartonella henselae and B. quintana, have been associated with Bacillary Angiomatosis, but culture and speciation are difficult, and there has been little systematic evaluation of the species-specific disease characteristics. We studied 49 patients seen over eight years who were infected with bartonella species identified by molecular techniques and who had clinical lesions consistent with Bacillary Angiomatosis–peliosis. Methods In this case–control study, a standardized questionnaire about exposures was administered to patients with Bacillary Angiomatosis–peliosis and to 96 matched controls. The infecting bartonella species were determined by molecular techniques. Results Of the 49 patients with Bacillary Angiomatosis–peliosis, 26 (53 percent) were infected wit...

  • Bacillary Angiomatosis and Bacillary splenitis in immunocompetent adults
    Annals of Internal Medicine, 1993
    Co-Authors: Jordan W. Tappero, Jane E Koehler, Clay J. Cockerell, Timothy G Berger, Tzonghae Lee, Michael P Busch, Daniel P Stites, Janet C Mohleboetani, Arthur L Reingold, Philip E. Leboit
    Abstract:

    Bacillary Angiomatosis and Bacillary peliosis have been described in patients with human immunodeficiency virus (HIV) infection and drug-induced immunosuppression. Patients with these vascular lesi...

  • the epidemiology of Bacillary Angiomatosis and Bacillary peliosis
    JAMA, 1993
    Co-Authors: Jordan W. Tappero, Jane E Koehler, Philip E. Leboit, Timothy G Berger, Janet C Mohleboetani, B Swaminathan, Laura L Smith, Jay D Wenger, Robert W Pinner, Carol A Kemper
    Abstract:

    Objective.\p=m-\Todetermine environmental risk factors for Bacillary Angiomatosis\x=req-\ Bacillary peliosis (BAP), and to confirm infection with Rochalimaea species. Design.\p=m-\Case-controlstudy. Setting.\p=m-\Community and university hospitals and clinics. Patients.\p=m-\Case patients (N=48) had biopsy-confirmed BAP. Controls (N=94) were matched to patients by institution and by human immunodeficiency virus (HIV) serological status. Main Outcome Measures.\p=m-\Clinicalinformation was obtained from medical records. Subjects were queried about environmental exposures. Univariate odds ratios (ORs) with 95% confidence intervals (Cls) were determined. Bivariate analyses were performed on variables associated with disease by univariate analysis. DNA from 22 available case-patient tissues and from 22 control tissues was amplified with the polymerase chain reaction (PCR) using primers designed to detect Rochalimaea species. Results.\p=m-\Weidentified five HIV-negative, immunocompetent case patients; one HIV-negative, immunodeficient case patient; and 42 HIV-positive case patients. There were no significant differences between case patients and controls by race, sex, age, or risk factors for HIV infection. Owning a cat (OR, 2.8; CI, 1.4 to 5.8) and history of a recent cat lick (OR, 1.95; CI, 1.0 to 3.8), cat scratch (OR, 3.7; CI, 1.7 to 8.0), or cat bite (OR, 3.9; CI, 1.8 to 8.9) were associated with disease in the univariate analysis. In bivariate analyses, only the variables representing traumatic contact with a cat (bite or scratch) remained associated with disease. No other environmental exposure was associated with disease. The PCR amplified a DNA fragment of the size expected for Rochalimaea species in all 22 case-patient tissue specimens. Conclusions.\p=m-\Thesedata suggest that BAP is a new zoonosis associated with both traumatic exposure to cats and infection with Rochalimaea species or a closely related organism.

  • isolation of rochalimaea species from cutaneous and osseous lesions of Bacillary Angiomatosis
    The New England Journal of Medicine, 1992
    Co-Authors: Jane E Koehler, Philip E. Leboit, Timothy G Berger, Frederick D Quinn, Jordan W. Tappero
    Abstract:

    Abstract Background. Bacillary Angiomatosis is characterized by vascular lesions, which occur usually in patients infected with the human immunodeficiency virus (HIV). A newly described gram-negative organism, Rochalimaea henselae, has been associated with cutaneous Bacillary Angiomatosis, but no organism has been isolated and cultivated directly from cutaneous tissue. Methods. We used two methods to isolate the infecting bacterium from four HIV-infected patients with cutaneous lesions suggestive of Bacillary Angiomatosis: cultivation with eukaryotic tissue-culture monolayers and direct plating of homogenized tissue onto agar. The patients' blood was cultured with the lysis—centrifugation method. Isolates recovered from skin and blood were identified by sequencing all or part of the 16S ribosomal RNA gene amplified with the polymerase chain reaction. Results. R. quintana, historically known as the agent of trench fever, was isolated from cutaneous lesions in three patients, after tissue homogenates were c...

  • Bacillary Angiomatosis a systemic opportunistic infection with prominent cutaneous manifestations
    Seminars in Dermatology, 1991
    Co-Authors: Philip E. Leboit
    Abstract:

    Bacillary Angiomatosis is an opportunistic infection with systemic manifestations. Although most cases have occurred in human immunodeficiency virus-positive patients, other immunosuppressed patients, and even seemingly immunocompetent individuals, can become infected. In addition to the well-characterized cutaneous manifestations, visceral involvement can occur and may be the only locus of infection. Lymphadenopathy, bone or soft-tissue masses, fever, and hepatosplenomegaly can be presenting signs. The causative bacterium is still unidentified, but resemblances to the rickettsiae, Rochilamea quintana, the recently identified cat-scratch disease bacillus, and Bartonella bacilliformis have been noted by various investigators. Systemic disease is treatable and can be cured with antibiotic therapy.

Pamela Jo Harris - One of the best experts on this subject based on the ideXlab platform.