細菌性血管腫症

[Bacillary angiomatosis].

• Pablo Uribe
• M Elvira Balcells
• Laura Giesen
• Consuelo Cárdenas
• Patricia García
• Sergio González

抄録

バチラリー血管腫症は、免疫不全患者に典型的な血管増殖性病変を伴う、珍しい感染症である。Bartonella quintanaとBartonella henselaeというBartonella属の2つの感染因子によって引き起こされ，皮膚血管病変や紫斑病変，局所リンパ節腫脹，さらには内臓病変を伴う全身性疾患など，様々な臨床症状を呈する．我々は38歳のHIV陽性男性を対象に，6ヵ月前から鼻腔，鼻咽頭，喉頭に紫斑性の皮膚血管腫性病変を発症した既往歴を報告する．皮膚生検では桿状血管腫症と診断された．組織サンプルのポリメラーゼ連鎖反応はB. quintana株Toulouseとの相同性を示した．この患者はアジスロマイシンとシプロフロキサシンで治療され、良好な進展を示した。

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.