Soft tissue
Benign vascular tumors
Bacillary angiomatosis

Author: Vijay Shankar, M.D. (see Authors page)

Revised: 13 September 2016, last major update November 2012

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Bacillary angiomatosis [title] soft tissue
Definition / General
  • Opportunistic infection of immunocompromised, first described in AIDS, manifesting as vascular proliferations in bone, CNS, skin, other organs
  • Rarely imunocompetent individuals (Indian J Dermatol Venereol Leprol 2010;76:682)
  • Caused by infection with Bartonella species (gram negative rods), either Bartonella henselae (causes cat-scratch disease, reservoir in cats, vector is cat flea), B. quintana (cause of trench fever during WW I, reservoir in humans, vector is human body louse) or other species; transmitted via traumatic inoculation of skin
  • Bacillary peliosis: related vascular lesion of liver and spleen
Case Reports
Treatment
  • Erythromycin
Clinical Images

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Palm, simulating pyogenic granulma, courtesy of Dr. Mark R. Wick

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Skin: nodules with ulceration

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Skin: at site of burn

Gross Description
  • Moist, eruptive, cutaneous lesion
Micro Description
  • Acute neutrophilic inflammation with vascular proliferation and prominent endothelial cells with nuclear atypia and mitotic figures
  • Nuclear dust and granular material (bacteria) present
  • Bacteria highlighted by silver stain
Micro Images

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Courtesy of Dr. Mark R. Wick



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Dermal lobular vascular proliferation with swollen endothelial cells and bacteria (Warthin-Starry)

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Mixed inflammation, capillary proliferation