Bacillary Angiomatosis: Symptoms, Causes, Treatment, Epidemiology, Diagnosis

Bacillary angiomatosis is a form of bacterial infection that can lead to the formation of skin lesions on your body. These lesions can form on the outer surface of your skin and can even grow on your internal organs such as your spleen, liver, and mucosal surfaces. Bacillary angiomatosis lesions often look similar to lesions of Kaposi sarcoma^{(1, 2)} and hence proper investigation and diagnosis are mandatory. In the course of this discussion, we will take a detailed look at some of the elemental aspects of this medical condition such as its symptoms, causes, processes of diagnosis, epidemiology, treatment, and prevention tips.

One of the main symptoms of the condition of bacillary angiomatosis is the emergence of skin lesions. These lesions can appear anywhere on the body but some of the most common places where these lesions can appear are the feet soles, the interiors of the mouth and also the palms of the hands^{(1, 3)}. These lesions in most of the cases have a reddish color and are raised and firm in their shape. Usually, these lesions are surrounded by a patch of scaly skin. If pricked, these lesions can bleed in a profuse manner. Bacillary angiomatosis can also have a couple of other symptoms that can accompany the emergence of skin lesions such as^(1):

• Vomiting and nausea
• Fever
• Chills or sweating
• swollen lymph
• Loss of appetite and so on.

Bacillary angiomatosis is a condition that occurs due to infections from either Bartonella henselae or Bartonella quintana. Both these bacteria are found in insects. Fleas and lice found in domestic cats are known to be the predominant source from where one can come in contact with these bacteria⁽⁴⁾. Bartonella henslae found in cat fleas is responsible for causing Bacillary angiomatosis is humans and can also cause scratch fever in cats. However, it is not mandatory for you to come in contact with cats to get contaminated by the bacteria. Both the bacteria causes’ cutaneous lesions; while Bartonella quintana causes soft osseous and subcutaneous lesions, Bartonella henselae is responsible for spleen and liver peliosis^(1).

It has been seen that people with a weak immune system often gets affected by the condition of bacillary angiomatosis. People suffering from organ transplants, HIV infection, cancer like leukemia and patients undergoing chemotherapy and drugs, chronic diabetes, affected by chronic infections like hepatitis B or are suffering from conditions such as common variable immunodeficiency or other immunity disorders are the ones who are commonly affected by the condition. However, even normal people who have been scratched by a cat or have an area or severe burn can also be affected by bacillary angiomatosis.^{(1, 5)}

In order to diagnose whether one is affected by the condition of bacillary angiomatosis, the doctor can ask for a number of tests and investigations.⁽¹⁾ Doctor will begin with the basic physical investigations and take a careful look at your medical history and track record.

Depending on your medical history and your visible and viable symptoms the doctor might do any of the following tests to diagnose the condition.⁽¹⁾

Serological Tests to Diagnose Bacillary Angiomatosis: In this form of testing a portion of serum is drawn from the blood collected from the affected region and it is checked for the presence of antibodies of the Bartonella bacteria.

Biopsy: The doctor collects a small sample of the skin from the area where the lesion has appeared. It is then tested for the presence of bacterial infection.

Molecular Testing to Diagnose Bacillary Angiomatosis: In this method of diagnosis, the doctor uses a genetic evaluation to detect the presence of the Bartonella DNA. It is done through a polymerase chain reaction done on the tissue sample.⁽⁴⁾

The condition of bacillary angiomatosis is treated with common antibiotics like doxycycline and erythromycin. People affected by bacillary angiomatosis might have to take the antibiotics for a span of three months. It is possible that the symptoms will begin to subside and improve within the first three or four weeks, even then the course might need to be continued for a little longer period. In case your symptoms do not improve even in one month, you might need to continue your antibiotics for a longer duration than three months⁽¹⁾. During this period, if any blister or lesion becomes particularly big or causes discomfort, your doctor might need to drain it.

If a patient is not able to tolerate doxycycline or erythromycin, he can be prescribed clarithromycin or azithromycin. Mild cutaneous lesion might require a treatment for 12 weeks or three months. If there is no response in the lesion size or color, the treatment period can be extended.

As a means of prevention, people with weak immune systems should stay away from cats or other forms of pets.

Bacillary angiomatosis is a condition that can be easily treated with common antibiotics. The condition is completely curable. However, it is imperative that the condition is diagnosed at a proper time and is treated in the correct way. If this is not provided to the patient then the situation can even turn out to be fatal. Hence, treating bacillary angiomatosis with proper care is imperative. If you have a cat at your home be sure to handle your pet with care and keep it as clean as possible. Bacillary angiomatosis is often contracted through cat scratches or through cat fleas. Although your cat could be infected with the bacteria for years, it might not have any symptoms for your cat. This is why cat owners are at a greater risk of contracting the bacteria and get affected by bacillary angiomatosis. If you have any of the symptoms visit a doctor as soon as possible and share all your problems and concerns in detail. This is how you can get the best possible help.

References: