Bacillary angiomatosis with cytomegaloviral and mycobacterial infections of the palpebral conjunctiva in a patient with AIDS.
We report the clinical and histopathologic findings of bacillary angiomatosis involving the palpebral conjunctiva with concomitant infection by cytomegalovirus and Mycobacterium species in a patient with acquired immune deficiency syndrome. After debulking, the conjunctival tissue was studied with the use of light and electron microscopy; stains for bacteria, acid-fast bacilli, and Bartonella species; and immunohistochemical studies for cytomegalovirus and herpes simplex virus. We observed the typical histopathologic findings of bacillary angiomatosis, the presence of bacilli stained by the Steiner and Steiner method, and the electron microscopic demonstration of bacilli consistent with Bartonella species. Immunohistochemistry confirmed infection with cytomegalovirus, which had been suggested by characteristic cytologic abnormalities. Acid-fast bacilli were also found in the excised tissue. Patients with bacillary angiomatosis of the conjunctiva may have infections with multiple additional microorganisms.
Edmonson
Brenda C
BC
Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.
Morris
William R
WR
Osborn
F David
FD
D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D016917:Angiomatosis, Bacillary / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D000900:Anti-Bacterial Agents; D000998:Antiviral Agents / Q000627:therapeutic use; D018416:Bartonella henselae / Q000302:isolation & purification; D003228:Conjunctiva / Q000382:microbiology; D003229:Conjunctival Diseases / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D015817:Eye Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D019909:Mycobacterium kansasii / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D000212:Acyclovir