title: Bacillary angiomatosis with atypical clinical presentation in an immunocompetent patient.
abstract: Bacillary angiomatosis is a recently described infectious disease that usually affects immunosupressed hosts with a previous history of contact with cats. We report a rare case of bacillary angiomatosis in an immunocompetent 59-year-old woman with no history of previous exposure to cats, and atypical clinical features (fever and subcutaneous nodules with ulceration on the left ankle). Histopathology of the lesion showed extensive ulceration and reactive tumor-like vascular proliferation of the blood vessels with swollen endothelial cells and an inflammatory infiltrate including neutrophils and lymphocytes in the dermis and subcutis. Staining with the Warthin-Starry method demonstrated the presence of clustered bacilli located in the extracellular matrix adjacent to the proliferating endothelial cells. Diagnosis was confirmed with the detection of Bartonella spp. DNA in the affected skin and in bone marrow using polymerase chain reaction.
authors.affiliation: Department of Dermatology, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain. jbernabeuw@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: Bernabeu-Wittel
authors.forename: R
authors.initials: R
authors.lastname: Luque
authors.forename: R
authors.initials: R
authors.lastname: Corbi
authors.forename: M
authors.initials: M
authors.lastname: Mantrana-Bermejo
authors.forename: M
authors.initials: M
authors.lastname: Navarrete
authors.forename: A
authors.initials: A
authors.lastname: Vallejo
authors.forename: M
authors.initials: M
authors.lastname: Bernabeu-Wittel
mesh_terms: D016917:Angiomatosis, Bacillary / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D001474:Bartonella Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D049109:Cell Proliferation; D003937:Diagnosis, Differential; D004318:Doxycycline / Q000494:pharmacology / Q000627:therapeutic use; D004730:Endothelium, Vascular / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host / Q000187:drug effects / Q000276:immunology*; D008875:Middle Aged
chemical_list: D004318:Doxycycline