Summary about Disease
Bacillary angiomatosis (BA) is a bacterial infection primarily affecting the skin and blood vessels. It is caused by bacteria of the Bartonella genus, most commonly *Bartonella henselae* and *Bartonella quintana*. BA typically occurs in individuals with weakened immune systems, such as those with HIV/AIDS, organ transplant recipients, or those undergoing immunosuppressive therapy. The disease is characterized by the proliferation of blood vessels, leading to the formation of lesions in the skin, liver, spleen, and other organs.
Symptoms
Symptoms of bacillary angiomatosis can vary depending on the location and severity of the infection. Common symptoms include:
Skin lesions: These are the most common manifestation and can appear as red, purple, or brown papules or nodules on the skin. They may be solitary or multiple, and they can be painful or painless. Lesions may bleed easily.
Systemic symptoms: In some cases, BA can affect internal organs, leading to symptoms such as fever, chills, night sweats, fatigue, weight loss, abdominal pain, bone pain, and enlarged liver or spleen.
Bone involvement: Bone pain is a possibility if there is bone involvement.
Causes
Bacillary angiomatosis is caused by bacteria of the Bartonella genus. The two most common species responsible for BA are:
Bartonella henselae: This bacterium is also the cause of cat-scratch disease.
Bartonella quintana: This bacterium is associated with trench fever and is often transmitted by body lice. Transmission typically occurs through:
Cat scratches or bites: Bartonella henselae is commonly carried by cats, and transmission can occur through scratches or bites.
Body lice: Bartonella quintana can be transmitted by body lice.
Medicine Used
Antibiotics are the primary treatment for bacillary angiomatosis. Common antibiotics used include:
Erythromycin: Often used as a first-line treatment.
Doxycycline: Another commonly used antibiotic.
Azithromycin: Can be used as an alternative, especially in those who cannot tolerate other antibiotics.
Other antibiotics: In some cases, other antibiotics such as clarithromycin, tetracycline, or aminoglycosides may be used, depending on the severity of the infection and the patient's individual circumstances.
Is Communicable
Bacillary angiomatosis itself is not directly communicable from person to person. The Bartonella bacteria are transmitted to humans through vectors, such as cat scratches/bites (*B. henselae*) or body lice (*B. quintana*). Therefore, it's the *Bartonella* infection that's transmitted via these vectors, leading to BA in susceptible individuals.
Precautions
Preventive measures include:
Avoiding cat scratches and bites: Exercise caution when handling cats, especially stray or feral cats. Wash any cat scratches or bites thoroughly with soap and water.
Controlling lice infestations: Maintain good hygiene and sanitation to prevent body lice infestations. If lice are present, seek appropriate treatment.
Personal hygiene: Regular handwashing, especially after contact with animals or potentially contaminated environments.
Immunocompromised individuals: Take extra precautions and consult with a healthcare provider about strategies to minimize the risk of Bartonella infection.
How long does an outbreak last?
With appropriate antibiotic treatment, symptoms of bacillary angiomatosis typically begin to improve within days to weeks. The duration of treatment usually ranges from several weeks to several months, depending on the severity and extent of the infection. Relapses can occur, particularly in immunocompromised individuals, requiring longer or repeated courses of antibiotics.
How is it diagnosed?
Diagnosis of bacillary angiomatosis typically involves:
Clinical examination: Physical examination of skin lesions and assessment of systemic symptoms.
Skin biopsy: A small sample of the affected skin is taken and examined under a microscope to identify characteristic features of BA and to detect the presence of Bartonella bacteria.
Blood tests: Blood cultures or PCR (polymerase chain reaction) tests can be performed to detect Bartonella DNA in the blood.
Imaging studies: Imaging tests such as CT scans or MRI may be used to assess involvement of internal organs.
Timeline of Symptoms
The timeline of symptoms can vary.
Incubation period: Varies, possibly days to weeks after exposure to Bartonella.
Initial symptoms: Skin lesions (papules, nodules) appear, often accompanied by fever, fatigue, and/or night sweats.
Progression: If untreated, lesions may enlarge, multiply, or ulcerate. Systemic symptoms may worsen, affecting liver, spleen, or bones.
Treatment: Symptoms generally improve within days to weeks of starting antibiotics.
Important Considerations
Immunocompromised status: Bacillary angiomatosis is most common and severe in individuals with weakened immune systems.
Differential diagnosis: BA can resemble other conditions, such as Kaposi's sarcoma or pyogenic granuloma, so accurate diagnosis is crucial.
Treatment adherence: Completing the full course of antibiotics is important to prevent relapse.
Underlying conditions: Managing underlying conditions, such as HIV/AIDS, is essential for preventing recurrence.
Veterinary consultation: If cat exposure is suspected, consult with a veterinarian to assess the cat for Bartonella infection and implement appropriate prevention measures.