Bacillary angiomatosis triggered by severe trauma in a healthy Caucasian patient: A case report

Abstract

Bacillary angiomatosis represents a cutaneous and systemic infection caused by Bartonella species, typically described in the past in HIV-positive patients or associated with immunodeficiencies. More recent case reports had brought into attention the probability that this entity may manifest in otherwise healthy individuals, triggered by trauma and skin burns. The physiopathology of this neoproliferative process is based on the production of angiogenetic molecules, such as vascular endothelial growth factor (VEGF) and IL-8. In case of an inadequate treatment, the evolution can be fatal, with a systemic dissemination of the abscesses within the gastro-intestinal tract, respiratory tract, brain and bones. The appropriate therapy is with oral erythromycin and doxycycline, but several treatments such as cephalosporins, penicillins, macrolides, aminoglycosides, rifampin, dapsone, ciprofloxacin, have been tried with favorable results. Herein we present the case of a Caucasian patient, seronegative for HIV, who developed multiple vascular papules and nodules on the face, after a severe trauma and which healed after an adequate antibiotic therapy with oral clarithromycin.

Bacillary Angiomatosis Mimicking Pyogenic Granuloma

“…Kaposi sarcoma is composed of ill-developed, slit-like spaces formed by atypical spindle cells [13], whereas pyogenic granuloma shows exuberant granulation tissue covered by hyperplastic or atrophic epithelium, which may show ulceration, numerous endothelium-lined blood vessels and proliferation of fibroblasts, and budding endothelial cells along with mixed inflammatory infiltrate [7]. So, based on the above histopathological findings, bacillary angiomatosis was given, which was also confirmed using special stains for bacterial colonies.…”

“…BA lesions most commonly involve the skin, but the involvement of the respiratory tract, bone, lymph nodes, gut, and brain are also reported. With trauma, the lesions may bleed profusely and be singular or multiple in number, but they rarely appear disseminated [6,7]. Oral cavity involvement is very rare, and only a few cases have been reported (oral mucosa, hard palate, lips, and alveolar bone); its appearance is almost similar to pyogenic granuloma clinically [8,9].…”

Acquired cutaneous angiomatosis and Chorioptes species dermatitis in an adult llama

“…While a specific classification scheme for veterinary angiomatosis is not yet available due to the paucity of cases, most lesions documented in animals less than one year of age are considered likely to be congenital or secondary to a congenital vascular malformation. 2 Other causes are considered acquired and are hypothesised to include sites of trauma, 3 vascular occlusion, 4 arteriovenous (AV) malformation, 5 or infections with bacteria or viruses. 6 7 The remaining cases are classified as idiopathic.…”

Bacillary Angiomatosis in an Immunocompetent Patient

“…[ 2 3 ] Table 1 summarizes the cases of BA in immunocompetent patients. [ 4 5 6 7 8 9 ] There is a slight female predominance (M: F = 4:5) with an age range of 10 to 65 years. The upper extremity is reportedly the commonest site, followed by the face and ankle.…”