title: Bacillary angiomatosis and bacillary peliosis in patients infected with human immunodeficiency virus: clinical characteristics in a case-control study.
abstract: Clinical characteristics associated with bacillary angiomatosis and bacillary peliosis (BAP) in patients with human immunodeficiency virus (HIV) infection were evaluated in a case-control study; 42 case-patients and 84 controls were matched by clinical care institution. Case-patients presented with fever (temperature, > 37.8 degrees C; 93%), a median CD4 lymphocyte count of 21/mm3, cutaneous or subcutaneous vascular lesions (55%), lymphadenopathy (21%), and/or abdominal symptoms (24%). Many case-patients experienced long delays between medical evaluation and diagnosis of BAP (median, 4 weeks; range, 1 day to 24 months). Case-patients were more likely than controls to have fever, lymphadenopathy, hepatomegaly, splenomegaly, a low CD4 lymphocyte count, anemia, or an elevated serum level of alkaline phosphatase (AP) (P < .001). In multivariate analysis, a CD4 lymphocyte count of < 200/mm3 (matched odds ratio [OR], 9.9; P < .09), anemia reflected by a hematocrit value of < 0.36 (OR, 19.7; P < .04), and an elevated AP level of > or = 2.6 mukat/L (OR, 23.9; P < .05) remained associated with disease after therapy with zidovudine was controlled for. BAP should be considered an AIDS-defining opportunistic infection and should be included in the differential diagnosis for febrile, HIV-infected patients with cutaneous or osteolytic lesions, lymphadenopathy, abdominal symptoms, anemia, or an elevated serum level of AP.
authors.affiliation: Childhood and Respiratory Disease Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Mohle-Boetani
authors.forename: J E
authors.initials: JE
authors.lastname: Koehler
authors.forename: T G
authors.initials: TG
authors.lastname: Berger
authors.forename: P E
authors.initials: PE
authors.lastname: LeBoit
authors.forename: C A
authors.initials: CA
authors.lastname: Kemper
authors.forename: A L
authors.initials: AL
authors.lastname: Reingold
authors.forename: B D
authors.initials: BD
authors.lastname: Plikaytis
authors.forename: J D
authors.initials: JD
authors.lastname: Wenger
authors.forename: J W
authors.initials: JW
authors.lastname: Tappero
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000276:immunology / Q000517:prevention & control; D000328:Adult; D016917:Angiomatosis, Bacillary / Q000150:complications* / Q000175:diagnosis* / Q000517:prevention & control; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D005260:Female; D015497:HIV-1; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010382:Peliosis Hepatis / Q000150:complications* / Q000175:diagnosis* / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents