When bacillary angiomatosis is a disease of the blood vessels. Bacillary angiomatosis is pseudoneoplastic and represents an infectious disease. The pathogen responsible for bacillary angiomatosis is the bacterial species Bartonella henselae. This is a bacterial germ that causes what is known as cat scratch disease. An infection with Bartonella quintana leads to bacillary angiomatosis somewhat less often.
What is Bacillary Angiomatosis?
Bacillary angiomatosis mostly affects people who suffer from a pronounced weakness of the body’s own immune system. This includes, for example, people with an HIV infection, which is why bacillary angiomatosis occurs particularly frequently in this group of patients. Basically, bacillary angiomatosis is a skin disease that occurs relatively rarely.
Bacillary angiomatosis occurs most frequently in HIV patients, and less often in patients with other weaknesses of the immune system. In these people, two types of bacteria are usually responsible for the development of bacillary angiomatosis, namely either Bartonella henselae or Bartonella quintana. These are the bacterial pathogens that cause cat scratch disease.
Bacillary angiomatosis manifests itself in characteristic changes on the skin that arise as a result of angiogenesis. In bacillary angiomatosis, for example, nodules and papules that are reddish-brown in color form on the skin. Ulcers and damage to the bones that occur over larger areas are also possible.
In bacillary angiomatosis, the skin changes are sometimes associated with chills, increased body temperature and other general symptoms. It is also possible that organs are affected by the symptoms due to bacillary angiomatosis. A osteolysis passes through the bacillary angiomatosis on frequently.
In addition, peliosis hepatis of the liver and so-called hepatosplenomegaly often develop. In addition, patients affected by bacillary angiomatosis sometimes suffer from aseptic meningitis, neuroretinitis and proliferative lesions in the central nervous system. Bacillary angiomatosis occurs in the majority of cases in HIV patients. Other people with a weakened immune system also have a particular risk of disease.
Causes
Bacillary angiomatosis is caused by infection with certain bacterial pathogens. The bacteria Bartonella quintana and Bartonella henselae in particular cause Bartonella quintana. These are also the two germs that cause cat scratch disease.
However, only about a third of all patients with bacillary angiomatosis have such contact with cats. Other favorable factors for the development of bacillary angiomatosis can be found in an HIV, EBV or CMV disease. The diseased cells lead to an increase in growth factors, so that a proliferation of the endothelial cells develops.
Symptoms, ailments & signs
The symptoms of bacillary angiomatosis are particularly evident on the skin. As a result of the increased proliferation of the capillaries, nodules and papules develop, which are distributed over the entire body and rarely appear in clusters in certain parts of the body. The papules are reddish to brown in color and occur either singly or in groups.
The color of the nodules depends in particular on how deep the lesions reach into the layers of the skin. The consistency of the papules is elastic, with ulcerations sometimes developing after a certain extent. The skin complaints of bacillary angiomatosis often lead to confusion with Kaposi’s sarcoma, which also occurs more frequently in HIV patients.
In some cases, bacillary angiomatosis also causes symptoms in the muscles, spleen, liver, lymph nodes and the eye. In about 25 percent of patients with bacillary angiomatosis, the bones are affected by the disease, with painful osteolytic foci.
Diagnosis & course
The diagnosis of bacillary angiomatosis should be made by a specialist doctor, such as a dermatologist. When taking the anamnesis, it is particularly important to understand possible chronic underlying diseases and immune deficiencies. An HIV disease already indicates bacillary angiomatosis.
The clinical examination also begins with an examination of the immune status of the patients suffering from bacillary angiomatosis. The doctor uses molecular genetic techniques to identify the pathogens responsible for bacillary angiomatosis, using either diseased skin tissue or the patient’s blood as the basis.
The study of bacillary angiomatosis requires extensive differential diagnosis. In doing so, the doctor rules out Kaposi’s sarcoma, granuloma teleangiectaticum, dermatofibromas and hemangiomas. The disease must also be differentiated from ulcerating pyoderma, papular exanthema, subcutaneous tumors, verruga peruana, syphilis type 2 or 3 and Oroya fever.
Complications
Bacillary angiomatosis is a rare skin disease that can be associated with pseudoneoplastic vascular disease. The symptom can affect people with severe immunodeficiency and is comparatively more likely to be found in HIV-infected patients. The disease is triggered by bacteria and pathogens causing the so-called cat scratch disease.
This can lead to complications even in non-exposed people due to the lengthy symptoms of the flu. Those affected with immunodeficiency are far more sensitive to bacillary angiomatosis. Reddish-colored nodules can form all over the body, either individually or in groups.
The larger and more plump the nodes grow, the sooner they can reach ulcer-like dimensions. If the symptoms are not treated, the dermatological lesions can cause chills, flare-ups, and headaches. In addition, the organs, lymph nodes, eyes, muscles as well as the entire central nervous system and the bone apparatus can become infected.
Meningitis or heart valve inflammation can be the most difficult complication. In order to alleviate serious problems associated with immunodeficiency, those affected, especially children and adolescents, must immediately seek medical advice. Bacillary angiomatosis can be determined microscopically and molecularly genetically.
After a thorough anamnesis, the therapy plan is drawn up. Here, the bacterial skin infection is successfully treated a priori with antibiotics both internally and externally. If the symptom occurs repeatedly, lifelong therapy must be targeted.
When should you go to the doctor?
Infectious bacillary angiomatosis mainly affects people with a weakened immune system. It is noticeable that it is mainly HIV patients who become infected with the bacterial pathogens that are also the cause of the so-called cat scratch disease. These are the bacterium Bartonella henselae and, far more rarely, Bartonella quintana. Cases in which people with an intact or artificially suppressed immune system are affected are very rare.
As soon as visible, elastic papules or nodules with a brown to reddish-brown color are evenly scattered over the entire surface of the skin, a dermatologist should be consulted for clarification and possible drug therapy. Even people with an intact immune system should definitely seek medical help.
For example, a differential diagnosis must be used to determine whether the symptoms of the skin conceal other serious diseases such as Kaposi’s sarcoma, various hemangiomas, tumors, syphilis and others. In addition, in a more severe course of bacillary angiomatosis, internal organs, primarily the liver and spleen, can also be affected.
In addition, there is a risk that the infection – if left untreated – can spread to lymph nodes, bones, eyes, muscles and even the CNS, with the consequence of serious permanent damage. If the infection spreads, it is usually associated with unspecific symptoms such as chills, fever attacks and headaches. The symptoms are similar to those of a flu-like infection.
Treatment & Therapy
The treatment of bacillary angiomatosis mainly uses drug approaches. Patients receive erythromycin either as an intravenous injection or in the form of tablets. With this form of therapy, the prognosis for bacillary angiomatosis is comparatively favorable.
At the end of a successful treatment, the changes on the skin usually also disappear. Hyperpigmentation sometimes remains on the damaged areas. In the case of individual lesions of bacillary angiomatosis, surgical removal, cryotherapy and curettage are also possible.
Outlook & forecast
The prognosis of bacillary angiomatosis is to be classified as favorable. In a drug treatment, the pathogens are fought so that they die and can be transported out of the organism. Following the therapy, the skin changes will heal as much as possible in the coming days and the patient will be free of symptoms.
The disease can also be cured without medical care. The organism can be strengthened and supported with various natural products. Due to the self-healing powers of humans, it is possible that a recovery takes place. In addition, creams can be applied that have a healing influence on the healing process of the skin. However, the healing path is significantly longer when choosing this method and requires a healthy and stable immune system.
If the person affected is weakened by other previous illnesses, complications can arise with the onset of bacillary angiomatosis, which have a negative impact on the patient’s health. If the pathogen manages to spread strongly, the self-healing powers are usually insufficient.
In addition, the risk increases that skin changes will persist after the pathogen has been eliminated. In most cases, the skin changes cannot completely regress. In medical treatment, the damaged areas of the skin are therefore treated further until the undesired skin changes have disappeared.
Prevention
Concrete ways of preventing bacillary angiomatosis are currently not known. Because consciously avoiding the causative germs is often difficult in reality. HIV patients take advantage of regular medical check-ups.
Aftercare
In the case of this disease, the person affected usually has no or only a few measures and options for follow-up care available, so that the person concerned is primarily dependent on a quick and above all on an early diagnosis in order to prevent further complaints or complications. In the worst case, the affected person can also die from this infection, since it cannot heal independently.
Therefore, an early diagnosis with subsequent treatment is in the foreground. In most cases, the symptoms are treated with medication. The patient is dependent on regular intake with the correct dosage in order to permanently and, above all, completely alleviate the symptoms.
If you have any questions or are unclear, you should primarily contact a doctor. Furthermore, the damaged areas on the skin should always be checked by a doctor so that a tumor does not develop. Life expectancy is usually not reduced by this disease. Contact with other sufferers can also be very useful with this disease.
You can do that yourself
In any case, bacillary angiomatosis requires extensive medical treatment. Medical therapy can be supported by dietary measures and the use of various remedies from homeopathy.
First of all, it is advisable to change your diet. Affected people should pay attention to balanced meals that must not be spicy or spicy. Certain foods such as onions or asparagus can reduce the typical skin irritation associated with the disease. The doctor will work with the patient to create an individual nutrition plan or refer the person to a nutritionist.
In addition to a change in diet, strict personal hygiene must be observed. Regular showering with gentle care products alleviates the characteristic itching and increases overall well-being. People who suffer from complaints of the eyes, muscles or internal organs should inform their doctor immediately. The bacillary angiomatosis may already have spread to other parts of the body and must be treated in a clinic.
People who suffer severely from the symptoms should seek medical treatment from a therapist. In a conversation with the specialist, fears and uncertainty, but also inferiority complexes triggered by skin changes, can be discussed and thus overcome more quickly.
