Verruga Peruana Mimicking Malignant Neoplasms

Arias‐Stella, Javier; Lieberman, Philip; García-Cáceres, Uriel; Erlandson, Robert A.; Krüger, H

doi:10.1097/00000372-198708000-00001

Cited by 51 publications

(10 citation statements)

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“…Histologically, the verrugas are characterized by a marked concentration of B. bacilliformis , both within the cytoplasm of endothelial cells and extracellularly in the surrounding interstitium. The existence of numerous capillaries and pseudocapillaries within verrugas suggests that Bartonella infection of endothelial cells provokes a local angiogenic response (Arias‐Stella et al ., 1987; Schneider et al ., 1993). Verrugas are histologically very similar to the haemangioma‐like lesions of bacillary angiomatosis, associated with infection by B. henselae in immunocompromised patients (Tappero et al ., 1993), as well as those observed in Kaposi's sarcoma.…”

Section: Introductionmentioning

confidence: 99%

Formation of stress fibres in human endothelial cells infected with Bartonella bacilliformis is associated with altered morphology, impaired migration and defects in cell morphogenesis

2001

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Bartonella bacilliformis, a Gram‐negative, flagellated bacterium, infects human erythrocytes (haematic phase) and endothelial cells (tissue phase), resulting in a biphasic disease. In the tissue phase of disease (verruga peruana), infection leads to infection of endothelial cells and a pronounced proliferation of these cells, resulting in characteristic skin eruptions of papules and nodules. We have studied the properties of endothelial cells infected in vitro. Extensive cytoskeletal remodelling of endothelial cells occurred after infection in vitro with B. bacilliformis. The cells became spindle shaped and contained arrays of actin stress fibres orientated parallel to the long axis of the cell. Cell–cell contacts were disrupted, along with the distribution of the plasma membrane marker protein, PECAM‐1, which participates in cell–cell junctions. The prominent stress fibres terminated in an increased number of focal contacts, which were studied using immunofluorescent staining for paxillin, a cytoplasmic protein that localizes in the focal adhesions. These morphological changes are consistent with activation of intracellular Rho by B. bacilliformis. Formation of stress fibres and the increased number of focal adhesions could be prevented by preincubation of the endothelial cells with C3 exoenzyme, which inactivates intracellular Rho by ADP ribosylation. Endothelial cell motility was greatly diminished in infected cells and the cells did not respond effectively to a stimulus that would evoke motility. In addition, infection of endothelial cells interfered with their ability to form networks of capillary tubes when suspended within three‐dimensional collagen matrices. If the properties of infected endothelial cells in vivo are similar, the infected cells will probably not participate effectively in angiogenesis.

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Section: Introductionmentioning

confidence: 99%

Formation of stress fibres in human endothelial cells infected with Bartonella bacilliformis is associated with altered morphology, impaired migration and defects in cell morphogenesis

2001

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“…The eruptive phase clinically resembles Kaposi's Sarcoma or Bacillary Angiomatosis [2,54,55]. Maguiña et al [3] reported 77 patients with the eruptive phase (mean age 18.4 years).…”

Section: Clinical Presentationmentioning

confidence: 99%

Bartonelosis (Carrion's Disease) in the pediatric population of Peru: an overview and update

Huarcaya¹,

Maguiña²,

Torres³

et al. 2004

Braz J Infect Dis

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DISA Jaen, Ministry of Health 3 , PeruBartonellosis, or Carrion's Disease, is an endemic and reemerging disease in Peru and Ecuador. Carrion's Disease constitutes a health problem in Peru because its epidemiology has been changing, and it is affecting new areas between the highland and the jungle. During the latest outbreaks, and previously in endemic areas, the pediatric population has been the most commonly affected. In the pediatric population, the acute phase symptoms are fever, anorexia, malaise, nausea and/or vomiting. The main signs are pallor, hepatomegaly, lymphadenopathies, cardiac murmur, and jaundice. Arthralgias and weight loss have also commonly been described. The morbidity and mortality of the acute phase is variable, and it is due mainly to superimposed infections or associated respiratory, cardiovascular, neurological or gastrointestinal complications. The eruptive phase, also known as Peruvian Wart, is characterized by eruptive nodes (which commonly bleed) and arthralgias. The mortality of the eruptive phase is currently extremely low. The diagnosis is still based on blood culture and direct observation of the bacilli in a blood smear. In the chronic phase, the diagnosis is based on biopsy or serologic assays. There are nationally standardized treatments for the acute phase, which consist of ciprofloxacin, and alternatively chloramphenicol plus penicillin G. However, most of the treatments are based on evidence from reported cases. During the eruptive phase the recommended treatment is rifampin, and alternatively, azithromycin or erythromycin.

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“…Verruga peruana is an eruptive angiomatous disease of the skin (Figs 3 and 4) that typically develops 2 months after an acute phase of bacteriemic disease known as Oroya fever or Carrion's disease. In addition to the casual presentation of the angiomatous lesions, 28,34 , 35 malignant‐looking aspects have been identified 36 . There is a great histological similarity between the disease BA in HIV‐positive individuals 37 .…”

Section: Verruga Peruanamentioning

confidence: 99%