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Bacillary angiomatosis in a human immunodeficiency virus negative patient: A rare case
Gaxa Luvo1, Hlatshwayo Bafana2
1MBChB, Senior Registrar, Diagnostic Radiology and Imaging, Polokwane-Mankweng Hospital Complex, Polokwane, Limpopo, South Africa.
2Dip Rad Diag, MBChB, MMed Rad D, Senior specialist, Diagnostic Radiology and Imaging, Polokwane-Mankweng Hospital Complex, Polokwane, Limpopo, South Africa.

Article ID: 100011CRINTGL2015
doi:10.5348/crint-2015-11-CR-6

Address correspondence to:
Bafana Elliot Hlatshwayo
P.O. Box 571, Kwa-Xuma
Gauteng 1868
South Africa
Phone: +27152875122
Fax: +27862600185

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How to cite this article:
Luvo G, Bafana H. Bacillary angiomatosis in a Human Immunodeficiency virus negative patient: A rare case. Case Rep Int 2015;4:22–25.


Abstract
Introduction: Although bacillary angiomatosis is generally known to be an opportunistic condition in immunosuppressed individuals there are extremely rare and exceptional occasions where it occurs in immunocompetent individuals. The incidence of bacillary angiomatosis in immunocompetent persons is not documented in the literature mainly due to the rarity of this condition in immunocompetent individuals. Routine histopathological evaluation helps in confirming the diagnosis of its varied presentations like infected lymphadenopathy, bone lesions, bacillary peliosis of the liver or the spleen as well as cutaneous bacillary angiomatosis. Giving four doses of 250–500 mg dose of erythromycin per day has proved to be the most successful treatment option and other antibiotics like Doxycycline 100 mg twice a day and ciprofloxacin are also showing good results.
Case Report: We report a retro viral disease negative in a seven-year-old girl who presented to us with a six-month history of bilateral neck fast growing masses. Birth history showed that the patient was delivered through a normal vaginal delivery with an uneventful birth history. The birth weight was 2.7 kg and the birth length was 46.5 cm. The Apgar score was 10/10. The body weight at presentation was 22 kg. The pulse 139/min, respiratory rate 24 bpm, temperature 36.2°C and 100% saturation. The diagnosis of bacillary angiomatosis was made on clinical, radiological and histopathological findings. The patient was treated with antibiotics and there is reduction in the degree of neck swelling on patient's follow-up ever since the treatment was initiated.
Conclusion: The diagnosis and the management of bacillary angiomatosis needs a teamwork of various specialists which includes but not limited to pediatric oncologists, radiologists and histopathologists. It is extremely uncommon to make a diagnosis of bacillary angiomatosis in HIV negative patients. There are no specific clinical or radiological features to confidently make a final diagnosis of bacillary angiomatosis and as a result biopsy has to always be performed to secure a final diagnosis.

Keywords: Bacillary angiomatosis, Human immunodeficiency virus, Lymphadenopathy, Negative


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Author Contributions
Luvo Gaxa – Substantial contributions to conception and design, acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Bafana Elliot Hlatshwayo – Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Luvo Gaxa et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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