RSS Feeds
Colonic Bacillary Angiomatosis
- Young B. Huh, MD;
- Suzanne Rose, MD;
- Robert E. Schoen, MD, MPH;
- Susan Hunt, MD;
- David C. Whitcomb, MD, PhD; and
- Sydney Finkelstein, MD
- From the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Requests for Reprints: Suzanne Rose, MD, University of Pittsburgh Medical Center, Division of Gastroenterology and Hepatology, 200 Lothrop Street, Mezzanine Level, C Wing, Presbyterian University Hospital, Pittsburgh, PA 15213. Current Author Addresses: Drs. Huh, Rose, Schoen, and Whitcomb: University of Pittsburgh Medical Center, Division of Gastroenterology and Hepatology, 200 Lothrop Street, Mezzanine Level, C Wing, Presbyterian University Hospital, Pittsburgh, PA 15213.
Bacillary angiomatosis is an infectious disease caused by small, fastidious, gram-negative bacilli known as Bartonella henselae and B. quintana (formerly Rochalimaea henselae and R. quintana) [1]. The infection is characterized by a vascular proliferation of the skin or visceral organs and usually occurs in immunosuppressed patients [2].
Cutaneous bacillary angiomatosis is the most common clinical form of bacillary angiomatosis. Skin lesions present as red papules, subcutaneous nodules, or cellulitic plaques [2-4]. Bartonella infection has also been seen in the lymph nodes, liver (bacillary peliosis hepatis), spleen, bone, heart, central nervous system, oropharynx, larynx, endobronchus, duodenum, and blood [3-5].
We report the first known case of bacillary angiomatosis of the colon. Our patient was a middle-aged man with the acquired immunodeficiency syndrome (AIDS), bloody diarrhea, and no cutaneous involvement. This case highlights a new treatable cause of diarrhea and intestinal bleeding in patients with AIDS.
Case Report
A 60-year-old homosexual man with AIDS and Crohn disease in remission was seen after having had abdominal cramps and pain, tenesmus, and bloody diarrhea for 8 weeks. Colonoscopy done 2 years earlier had shown deep serpiginous ulcerations in the rectosigmoid region. Biopsy specimens had shown mucosal erosions and hemorrhage and a lymphoplasmacytic infiltrate. The endoscopic and histologic features of the remainder of the colon and the terminal ileum were normal, compatible with Crohn proctosigmoiditis. The patient …
