BACILLARY ANGIOMATOSIS IN A GERMAN PATIENT WITH AIDS

A 52-year old male homosexual patient with acquired immunodeficiency s yndrome (AIDS) presented in our clinic with multiple nodular papules ( more than 100) spread over the whole body which had developed within 3 months. Bacillary angiomatosis was suspected, which is a bacterial in fectious disease recognized recently mainly in patients with AIDS. His tological and immunohistochemical examinations of extirpated skin lesi ons were in agreement with the diagnosis, and the detection of rod-sha ped bacteria in the lesions by Warthin-Starry silver stain confirmed i t. The patient was treated with 2x100 mg doxycycline per day. The feve r disappeared, and the cutaneous lesions showed a slight tendency to i mprove. However, after 5 days of therapy the patient showed increasing weakness, with muscle and bone pain. The patient died 10 days after t he doxycyline therapy had been started. The cutaneous lesions in bacil lary angiomatosis may resemble Kaposi's sarcoma and may therefore be m isdiagnosed. The disease may be fatal, but timely antibiotic treatment is usually effective; therefore the diagnosis of bacillary angiomatos is is important. Although many cases have been reported from the Unite d States, only one case is known from Europe. Our finding of bacillary angiomatosis in a German AIDS patient supports the concept of a world wide distribution of this bacterial agent.