Bacillary angiomatosis masquerading as Kaposi's sarcoma in East Africa
Autor: | Forrestel, AK, Naujokas, A, Martin, JN, Maurer, TA, McCalmont, TH, Laker-Opwonya, MO, Mulyowa, G, Busakhala, N, Amerson, Erin H |
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Rok vydání: | 2015 |
Předmět: |
Adult
Angiomatosis bacillary angiomatosis Kaposi Fingers Young Adult Kaposi’s sarcoma Fatal Outcome Rare Diseases Diagnosis Humans 2.1 Biological and endogenous factors Aetiology Bacillary AIDS-Related Opportunistic Infections HIV Sarcoma dermatology Vector-Borne Diseases Cheek Emerging Infectious Diseases Infectious Diseases Good Health and Well Being Differential Africa Arm HIV/AIDS Female Infection |
Zdroj: | Journal of the International Association of Providers of AIDS Care, vol 14, iss 1 |
Popis: | BackgroundBacillary angiomatosis (BA) is a rare manifestation of infection caused by Bartonella species, which leads to vasoproliferative lesions of skin and other organs. Bacillary angiomatosis affects individuals with advanced HIV disease or other immunocompromised individuals. In sub-Saharan Africa, despite the high prevalence of HIV infection and documentation of the causative Bartonella species in humans, mammalian hosts, and arthropod vectors, BA has only rarely been described.MethodsThree adult patients from Uganda and Kenya with deep purple dome-shaped papules or nodules of the skin underwent punch biopsies for histopathologic diagnosis. The biopsies of all 3 patients were sent to a local pathologist as well as to a dermatopathologist at the University of California, San Francisco.ResultsAll 3 patients were clinically suspected to have Kaposi's sarcoma (KS), and local pathologists had interpreted the lesions as KS in 2 of the cases and nonspecific inflammation in the third. Histologic examination by dermatopathologists in the United States revealed nodular dermal proliferations of irregular capillaries lined by spindled to epithelioid endothelial cells. The surrounding stroma contained a mixed inflammatory infiltrate with lymphocytes, eosinophils, and neutrophils. Extracellular deposits of pale amphophilic granular material were noted in the surrounding stroma. A Warthin-Starry stain highlighted clumps of bacilli, confirming the diagnosis of BA.ConclusionsThese 3 cases, to our knowledge, are the first reports of BA in East Africa in the biomedical literature. Each had been originally incorrectly diagnosed as KS. We speculate BA is underdiagnosed and underreported in resource-poor regions, such as sub-Saharan Africa, that have high endemic rates of HIV infection. |
Databáze: | OpenAIRE |
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