Document 0236
 DOCN  M95B0236
 TI    Cutaneous bacillary angiomatosis in a patient with chronic lymphocytic
       leukemia.
 DT    9511
 AU    Milde P; Brunner M; Borchard F; Sudhoff T; Burk M; Zumdick M; Goerz G;
       Ruzicka T; Department of Dermatology, Heinrich-Heine-University of;
       Dusseldorf, Germany.
 SO    Arch Dermatol. 1995 Aug;131(8):933-6. Unique Identifier : AIDSLINE
       MED/95358608
 AB    BACKGROUND: Bacillary angiomatosis is a recently described vascular
       disorder that is associated with infection by Bartonella henselae
       (formerly known as Rochalimaea henselae) and Bartonella quintana
       (formerly known as Rochalimaea quintana); this disorder usually occurs
       in patients with human immunodeficiency virus infection. We report a
       case of cutaneous bacillary angiomatosis that occurred in a patient with
       chronic lymphocytic leukemia. OBSERVATIONS: A 55-year-old man with
       chronic lymphocytic B-cell leukemia, Rai stage IV, presented with
       multiple angiomatous papules that clinically resembled pyogenic
       granulomas. Histopathologic examination revealed circumscribed lobules
       of small vessels with plump endothelial cells, numerous neutrophils, and
       abundant nuclear dust; these features were diagnostic for bacillary
       angiomatosis. The diagnosis was confirmed by the Grocott-Gomori
       methenamine-silver nitrate stain that revealed argyrophilic bacteria and
       by ultrastructural demonstration of bacillary structures with trilaminar
       walls. Treatment with clarithromycin led to complete resolution of the
       lesions within 4 weeks. CONCLUSIONS: This case emphasizes that (1)
       bacillary angiomatosis must be considered in the differential diagnosis
       of vascular lesions in immunocompromised patients without human
       immunodeficiency virus infection, (2) Grocott-Gomori methenamine-silver
       nitrate stain is a simple and satisfactory alternative to the
       Warthin-Starry stain for the demonstration of bacilli in this condition,
       and (3) clarithromycin is an effective oral antibiotic for the treatment
       of this disease.
 DE    Angiomatosis, Bacillary/*COMPLICATIONS/DRUG THERAPY/MICROBIOLOGY/
       PATHOLOGY  Case Report  Clarithromycin/THERAPEUTIC USE  Human  Leukemia,
       B-Cell, Chronic/*COMPLICATIONS  Male  Middle Age  Stains and Staining
       JOURNAL ARTICLE

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