Bacillary Angiomatosis Differential Diagnoses

Updated: Jun 05, 2020
  • Author: KoKo Aung, MD, MPH, FACP; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
  • Print
DDx

Diagnostic Considerations

Differential diagnosis of bacillary angiomatosis includes the following:

  • Common wart

  • Hemangioma

  • Angiokeratoma

  • Verruga peruana

  • Infections caused by Mycobacterium haemophilum, M kansasii, and M marinum

  • Bacterial abscess

  • Cavernous hemangioma

  • Nodal myofibromatosis

Kaposi sarcoma

A multiplexed 1-pot colorimetric detection system for DNA from a frequently confounding disease, Kaposi sarcoma, and from Kaposi sarcoma-associated herpesvirus has been developed using gold and silver nanoparticles. [38]

Failure to distinguish Kaposi sarcoma from bacillary angiomatosis is problematic because bacillary angiomatosis, unlike Kaposi sarcoma, responds dramatically to antibiotic therapy. Furthermore, bacillary angiomatosis may be life threatening if untreated. Because the 2 diseases may coexist, the lesions of bacillary angiomatosis may be easily overlooked.

Cat scratch disease

B henselae and B quintana may stain positively with a specific antiserum against the cat scratch bacillus. Bacillary angiomatosis, however, causes a vascular proliferation, not a formation of stellate abscesses without granuloma formation, as found in cat scratch disease. In addition, unlike patients with bacillary angiomatosis, those with cat scratch disease do not respond to antibiotics.

Verruga peruana and Oroya fever

The organisms causing bacillary angiomatosis resemble the agent of verruga peruana and Oroya fever, Bartonella bacilliformis, in producing a histologically similar vascular proliferation, in having a gram-negative wall structure (as observed using electron microscopy), and in tending to grow in clumps visible by light microscopy. Oroya fever is transmitted by an insect vector (a Peruvian sandfly) present only in a mountainous region of Peru near the city of Oroya.

Differentials

Angiosarcoma

Catscratch Disease

Cryptococcosis

Histoplasmosis

Kaposi Sarcoma

Sporotrichosis

Acneiform Eruptions

Glomus Tumor

Pyogenic granuloma

Dermatofibroma

Epithelioid angiomatous nodule