Bacillary Angiomatosis
David Cassarino, MD, PhD
Key Facts
Terminology
Reactive vascular proliferation associated with Bartonella (gram-negative coccobacilli) bacterial infection
Etiology/Pathogenesis
Most patients are immunosuppressed, especially HIV/AIDS
Also associated with organ transplantation, systemic steroids, and leukemia
Clinical Issues
Can involve any cutaneous site; uncommonly involves mucosal sites, deep soft tissues
Microscopic Pathology
Nodular to dome-shaped/polypoid dermal-based vascular proliferation
Infiltrate of neutrophils with nuclear dust, macrophages, focal clumps of basophilic granular material (bacteria)
 Low-power examination of bacillary angiomatosis demonstrates a superficial dermal proliferation of blood vessels in a lobular configuration  associated with edema and inflammation. |
 Warthin-Starry silver stain preparation shows numerous clusters of bacterial organisms  around blood vessels. |
TERMINOLOGY
Abbreviations
Bacillary angiomatosis (BA)
Synonyms
Epithelioid angiomatosis
Definitions
Reactive vascular proliferation associated with Bartonella species bacterial infection
ETIOLOGY/PATHOGENESIS
Infectious Agents
Caused by infection with Bartonella (gram-negative coccobacilli) species, usually B. henselae or B. quintana
Most patients have a history of cat exposure (and may have preceding scratch or bite)
Most patients are immunosuppressed, especially due to HIV/AIDS
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