Bacillary Angiomatosis Follow-up

  • Author: KoKo Aung, MD, MPH, FACP; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Sep 6, 2011
 

Further Outpatient Care

  • For cutaneous lesions, the number and size of the lesions should be monitored to determine the efficacy of treatment.
  • For visceral involvement, imaging study findings, hepatic transaminase levels, organomegaly, and/or lymph node enlargement should be monitored to determine response to therapy.
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Deterrence/Prevention

  • Prevention of bacillary angiomatosis associated with B henselae infection is as follows:
    • Avoid cat contact.
    • Control flea infestations in cats.
  • Prevention of bacillary angiomatosis associated with B quintana infection is as follows:
    • Delousing procedures, such as permethrin dusting powder (1%, 30-50 g per adult), can be used.
    • Clothing and bedding should also be treated.
  • Use of macrolides for Mycobacterium avium-intracellulare prophylaxis in patients infected with HIV is protective against bacillary angiomatosis.
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Complications

  • Disfigurement
  • Biliary obstruction and jaundice
  • Gastrointestinal bleeding
  • Encephalopathy
  • Laryngeal obstruction and asphyxiation
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Prognosis

  • The prognosis of bacillary angiomatosis itself is excellent because antibiotics are curative in most patients.
  • Untreated bacillary angiomatosis may be progressive and life-threatening.
  • The lesions resolve completely after treatment. Hyperpigmentation or slight induration at the site of a lesion may persist indefinitely. Relapses can occur after cessation of therapy and are common in immunocompromised hosts.
  • Treatment may be more difficult and requires a longer duration of therapy if the diagnosis is delayed.
  • Overall prognosis depends on early detection and treatment and the degree of immunosuppression.
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Patient Education

  • Immunocompromised patients and their caregivers should be advised to avoid cat contact and to control flea infestations in cats.
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Contributor Information and Disclosures
Author

KoKo Aung, MD, MPH, FACP  Associate Professor, Department of Medicine, University of Texas Health Science Center at San Antonio; Adjunct Associate Professor of Public Health, University of Texas School of Public Health

KoKo Aung, MD, MPH, FACP is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Thwe T Htay, MD  Assistant Professor, Department of Medicine, University of Texas Health Science Center at San Antonio

Thwe T Htay, MD is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Romeo Papica II  MD, Staff Physician Premier Physicians

Disclosure: Nothing to disclose.

Harvey Kantor, MD  Chief, Professor, Department of Internal Medicine, Division of Infectious Diseases, Texas Tech University Health Science Center

Harvey Kantor, MD is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, Illinois State Medical Society, Infectious Diseases Society of America, New York Academy of Sciences, Royal Society of Medicine, and Sigma Xi

Disclosure: Nothing to disclose.

Hesham M Elgouhari, MD  Hepatology/Transplant Hepatology Fellow, Cleveland Clinic

Hesham M Elgouhari, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Medical Association, American Society of Transplantation, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Gary L Gorby, MD  Associate Professor, Departments of Internal Medicine and Medical Microbiology and Immunology, Division of Infectious Diseases, Creighton University School of Medicine; Associate Professor of Medicine, University of Nebraska Medical Center; Associate Chair, Omaha Veterans Affairs Medical Center

Gary L Gorby, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, and New York Academy of Sciences

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Joseph F John Jr, MD, FACP, FIDSA, FSHEA  Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina College of Medicine; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

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