IADVL
Indexed with PubMed and Science Citation Index (E) 
 
Users online: 6489 
     Home | Feedback | Login 
About Current Issue Archive Ahead of print Search Instructions Online Submission Subscribe What's New Contact  
  Navigate here 
  Search
 
   Next article
   Previous article 
   Table of Contents
  
 Resource links
   Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
  Related articles
   [PDF Not available] *
   Citation Manager
   Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
* Registration required (free)  

 
  In this article
    Abstract
    Introduction
    Case Report
    Discussion
    References

 Article Access Statistics
    Viewed4763    
    Printed95    
    Emailed2    
    PDF Downloaded1    
    Comments [Add]    

Recommend this journal

 
CASE REPORT
Year : 2001  |  Volume : 67  |  Issue : 1  |  Page : 37-38

Bacillary angiomatosis in an immune-competent patient


Department of Dermatology, R.K.M. 5eva Pratisthan, Calcutta- 700 026, India

Correspondence Address:
E-4, CGHS Dispensary, Dr. Zakir Hussain Marg, Pundar, India

   Abstract 

Bacillary angiomatosis is reported in a 65- year- old man. He was immunocompetent and the lesions subsided following treatment with oral erythromycin.

How to cite this article:
Gangopadhyay AK, Sharma P K. Bacillary angiomatosis in an immune-competent patient. Indian J Dermatol Venereol Leprol 2001;67:37-8


How to cite this URL:
Gangopadhyay AK, Sharma P K. Bacillary angiomatosis in an immune-competent patient. Indian J Dermatol Venereol Leprol [serial online] 2001 [cited 2019 Aug 20];67:37-8. Available from: http://www.ijdvl.com/text.asp?2001/67/1/37/8133



   Introduction Top

Bacillary angiomatosis (BA)- a recently de­scribed entity caused by a rickettsia, is a rare disor­der characterised by angiomatous lesion in the skin, mucosa and internal organs. BA is mostly associ­ated with acquired immunodeficiency syndrome (AIDS), rarely with other immunodeficient states and very rarely in healthy person.[1] BA is rarely reported in Indian literatures. Here is a report of such a very rare case.

   Case Report Top

An elderly person of 65 years, business- man by profession presented with multiple erythematous, nonpruritic, papular and plaque type of eruptions over the extensor aspect of the right forearm for the last two months. The patient was otherwise alright and denied history of exposure or homosexuality, nor he was on any immunosuppressive drugs. Ex­amination revealed around ten reddish brown pap­ules and plaques of varying sizes-1.5 cm to 2.5 cm in diameter distributed over the forearm in a linear fashion. The lesions blanched partially on diascopy. There was no mucous membrane lesion, no lymphad­enopathy, or hepato- splenomegaly. Routine blood test and urinalysis showed no abnormality. Erythro­cyte sedimentation rate was 20mm 1st hour. Blood sugar was 130mg. (post prandial). Chest x-ray and ultrasound study of abdomen did not reveal any pa­thology. Liver biopsy was not done due to inherent risk of bleeding from the angiomatous lesion, if present. Mantoux test was positive. Serum IgG was 850 mg/dl. (normal 723-1685). Serum 1gM was 120 mg/d1. (normal 60-263 mg/d1) by Rate nephlometric principle. VDRL test and ELISA tests for HIV were negative. Histology showed neovascularisation in the upper dermis. The endothelial cells of the capillaries were enlarged with clear cytoplasm giving it an appearance of epitheloid cell. There was no cellular atypia. There was not much inflammatory infiltrate nor any accumulation of eosinophils. The patient was put on a course of erythromycin (500 mg.) four times daily. The lesions disappeared completely in a course of 15 days. Identification of the causative bacillus could not be done due to lack of laboratory facility.

   Discussion Top

BA is rather a new entry in medical vocabu­lary. It was first described by Stoler et al in 1983, in an AIDS patient with multiple subcutaneous tumours accompanied by fever, sweating and weight loss.[2] Later on Cockrell et al reported similar cases.[2] Their patients in addition to skin lesions had lesions in the liver and bone. Initial epidemiological and histopatho­logical data suggested that the causative agent of BA is the cat scratch disease bacillus. But the lack of associated cat contact, different clinical pattern and the response to erythromycin suggest that the bac­teria are not identical. A gram negative bacillus­
Rochalimaca henselae - is the bacillus recently recognised as the causative agent of BA. This bacil­lus is demonstrated by a special stain called Warthen­-Starry stain and by electron microscopic study where it appears as bacillary form with a trilamillar cell wall. The diagnosis in this particular patient was made from the unique clinical features and histological find­ings of neo-vascularisation in an elderly person and the therapeutic response to erythromycin. The most common risk factor for BA is HIV infection. This par­ticular case reported herein is one of those very few patients of BA where the person is competent immunologically. 

   References Top

1.Johnson RA, Dover JS. Cutaneous manifestation of human immuno deficiency virus disease. in: Dermatology in General Medicine (Fitzpatrick TB, Eie AZ, Wolft K, et al. Fitzpatrick, Eisea eds) vol. 2, 4th ed. Macgrow Hill Inc., New York, 1993, P 2674.  Back to cited text no. 1    
2.Benger TG, Geene I. Bacterial, viral, fungal and parasitic infection in HIV disease and AIDS - in: Dermatologic Clinics Vol. 9 Editor B.H. Thiers & LTC William James, W.B. Saunders Company, Philadelphia, 1991, p 465-492.  Back to cited text no. 2    

 

Top
Print this article  Email this article
Previous article Next article

    

Online since 15th March '04
Published by Wolters Kluwer - Medknow