RESUMO
BACKGROUND: Sickle cell disease (SCD) is the most prevalent hematologic genetic disorder. Acute vaso-occlusive painful crisis is the hallmark of the disease and may be related to subclinical infections. Bartonellosis, a rare and neglected infection, is caused by Bartonella spp., which can be found in donated blood. These bacteria cause intraerythrocytic and endothelial infection and pain, all of which occur in SCD. It is likely that this infection is transmitted to SCD patients during transfusion from donated blood, leading to pain. We, therefore, evaluated whether Bartonella henselae infection would cause hyperalgesia in mice with SCD. MATERIALS AND METHODS: SCD mice were generated by transplantation of nucleated bone marrow cells harvested from transgenic Berkeley sickle mice into 2-month-old irradiated C57BL/6 mice. We infected four SCD mice by intraperitoneal inoculation with B. henselae, and inoculated four other mice with the same volume of saline. Mechanical hyperalgesia was determined using von Frey monofilaments by two blinded observers. Thereafter, the animals were anesthetized and euthanized to collect blood, liver, and spleen samples to seek B. henselae infection by PCR. FINDINGS: We confirmed the experimental infection in all animals by PCR. Tremors and mechanical hypersensitivity were demonstrated by SCD mice infected with B. henselae infection but not in those receiving saline. CONCLUSION: B. henselae infection may be related to pain and other symptoms in SCD.
Assuntos
Angiomatose Bacilar/patologia , Bartonella henselae , Hiperalgesia/etiologia , Anemia Falciforme , Animais , DNA Bacteriano , Camundongos , Reação em Cadeia da PolimeraseRESUMO
Bacillary angiomatosis (BA) is an angioproliferative disease of immunocompromised patients that usually presents as vascular tumors in the skin and subcutaneous tissues. It is caused by chronic infections with either Bartonella henselae or B. quintana. Oral cavity BA is exceedingly rare and even rarer without simultaneous cutaneous disease. We report herein the case of a 51-year-old HIV-infected man who presented severe odynophagia and an eroded lesion on the hard palate that progressed to an oronasal fistula. No cutaneous lesions were recorded. Doxycycline led to complete resolution. To the best of our knowledge, only six previous cases of oral BA without tegumentary disease have been previously reported and none of them progressed to fistula.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/patologia , Angiomatose Bacilar/patologia , Doenças da Boca/patologia , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Boca/microbiologiaRESUMO
Abstract Bacillary angiomatosis is an infection determined by Bartonella henselae and B. quintana, rare and prevalent in patients with acquired immunodeficiency syndrome. We describe a case of a patient with AIDS and TCD4+ cells equal to 9/mm3, showing reddish-violet papular and nodular lesions, disseminated over the skin, most on the back of the right hand and third finger, with osteolysis of the distal phalanx observed by radiography. The findings of vascular proliferation with presence of bacilli, on the histopathological examination of the skin and bone lesions, led to the diagnosis of bacillary angiomatosis. Corroborating the literature, in the present case the infection affected a young man (29 years old) with advanced immunosuppression and clinical and histological lesions compatible with the diagnosis.
Assuntos
Humanos , Masculino , Adulto Jovem , Angiomatose Bacilar/patologia , Infecções Oportunistas Relacionadas com a AIDS/patologia , Biópsia , Ceftriaxona/uso terapêutico , Resultado do Tratamento , Angiomatose Bacilar/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Azitromicina/uso terapêutico , Bartonella henselae , Osso Esponjoso/patologia , Antibacterianos/uso terapêuticoRESUMO
Bacillary angiomatosis is an infection determined by Bartonella henselae and B. quintana, rare and prevalent in patients with acquired immunodeficiency syndrome. We describe a case of a patient with AIDS and TCD4+ cells equal to 9/mm3, showing reddish-violet papular and nodular lesions, disseminated over the skin, most on the back of the right hand and third finger, with osteolysis of the distal phalanx observed by radiography. The findings of vascular proliferation with presence of bacilli, on the histopathological examination of the skin and bone lesions, led to the diagnosis of bacillary angiomatosis. Corroborating the literature, in the present case the infection affected a young man (29 years old) with advanced immunosuppression and clinical and histological lesions compatible with the diagnosis.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/patologia , Angiomatose Bacilar/patologia , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Angiomatose Bacilar/tratamento farmacológico , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Bartonella henselae , Biópsia , Osso Esponjoso/patologia , Ceftriaxona/uso terapêutico , Humanos , Masculino , Resultado do Tratamento , Adulto JovemAssuntos
Angiomatose Bacilar/veterinária , Bartonella henselae , Colangite/veterinária , Hepatite Animal/microbiologia , Doenças dos Cavalos/microbiologia , Fígado/microbiologia , Angiomatose Bacilar/complicações , Angiomatose Bacilar/patologia , Animais , Colangite/etiologia , Colangite/microbiologia , Hepatite Animal/etiologia , Hepatite Animal/patologia , Doenças dos Cavalos/patologia , Cavalos/microbiologia , Fígado/patologia , MasculinoRESUMO
Background: Bacillary angiomatosis is an unusual infectious disease, with angioproliferative lesions, typical of immunocompromised patients. It is caused by Bartonella quintana and Bartonella henselae, two infectious agents of the genus Bartonella, which trigger variable clinical manifestations, including cutaneous vascular and purpuric lesions, and regional lymphadenopathy, and even a systemic disease with visceral involvement. We report a 38-year-old HIV positive male presenting with a history of six months of cutaneous growing purple angiomatous lesions, located also in nasal fossae, rhi-nopharynx and larynx. The skin biopsy was compatible with bacillary angiomatosis. Polymerase chain reaction of a tissue sample showed homology with B. quintana strain Toulouse. The patient was treated with azithromycin and ciprofloxacin with a favorable evolution.
Assuntos
Adulto , Humanos , Masculino , Infecções Oportunistas Relacionadas com a AIDS/patologia , Angiomatose Bacilar/patologia , Bartonella quintana , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Angiomatose Bacilar/tratamento farmacológico , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Biópsia , Ciprofloxacina/uso terapêuticoRESUMO
Bacillary angiomatosis is an unusual infectious disease, with angioproliferative lesions, typical of immunocompromised patients. It is caused by Bartonella quintana and Bartonella henselae, two infectious agents of the genus Bartonella, which trigger variable clinical manifestations, including cutaneous vascular and purpuric lesions, and regional lymphadenopathy, and even a systemic disease with visceral involvement. We report a 38-year-old HIV positive male presenting with a history of six months of cutaneous growing purple angiomatous lesions, located also in nasal fossae, rhi-nopharynx and larynx. The skin biopsy was compatible with bacillary angiomatosis. Polymerase chain reaction of a tissue sample showed homology with B. quintana strain Toulouse. The patient was treated with azithromycin and ciprofloxacin with a favorable evolution.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/patologia , Angiomatose Bacilar/patologia , Bartonella quintana , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Adulto , Angiomatose Bacilar/tratamento farmacológico , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Biópsia , Ciprofloxacina/uso terapêutico , Humanos , MasculinoAssuntos
Angiomatose Bacilar/diagnóstico , Angiomatose Bacilar/tratamento farmacológico , Bartonella henselae/isolamento & purificação , Complicações Infecciosas na Gravidez/diagnóstico , Adulto , Angiomatose Bacilar/patologia , Eritromicina/uso terapêutico , Feminino , Humanos , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/patologiaRESUMO
Bartonella spp. constitute emerging pathogens of worldwide distribution. Bacillary angiomatosis is the most frequent skin manifestation of bartonelloses; nevertheless, B. henselae infection should always be considered systemic, especially in immunodeficient individuals. The authors report the case of an AIDS patient with bacillary angiomatosis, who had concurrent severe anemia, hepatitis, peritonitis, pleuritis, and pericarditis. Clinical manifestation, electronic microscopic examination of erythrocytes, and histopathology of a papule biopsy suggested a Bartonella sp. infection. Multiple genes were target by PCR and B. henselae DNA was amplified and sequenced (GenBank accession number EF196804) from the angiomatous papule. Treatment with clarithromycin resulted in resolution of the bacillary angiomatosis, fever, anemia, panserosites, and hepatitis.