Chest ImagingBacillary angiomatosis
a fairly recently described illness caused by
Bartonella (Rochalimaea) henselae, a bacterium difficult to culture and only shown recently by DNA testing not to be a rickettsia. The organism particularly affects HIV-infected patients producing characteristic erythematous, well-circumscribed skin lesions which are tender and may bleed. Disseminated disease affecting multiple organ systems including the liver, spleen, central nervous system and
lymph nodes has been seen in
AIDS patients. Within the lung well or poorly defined lung nodules measuring up to 1.5 cm have been described, as has
peribronchovascular interstitial thickening. Other findings including endobronchial polyps have been reported in at least two HIV-infected patients.
Hilar lymphadenopathy and
pleural effusion were also seen in association with these individuals but a direct relationship to
B. henselae was not necessarily implied. Low attenuation lesions in liver and spleen, and enhancing lesions in the brain may be seen at
CT.
Clinical symptoms include fever, anaemia, and erythematous skin lesions. Treatment with erythromycin or doxycycline may result in rapid improvement of symptoms and radiographic abnormalities. Domestic cats are a reservoir for B. henselae but the method of transmission is unclear. The skin lesions are similar to those seen with Kaposis sarcoma. If not treated the disease may be fatal.
PGO