peliosis

Two morphologic patterns of hepatic peliosis were described by Yanoff and Rawson.

These diseases include bacillary angiomatosis and bacillary peliosis.

Withdrawal of azathioprine leads to remission in renal transplant, bacillary peliosis responds to antibiotics.

Bacillary peliosis responds more slowly than cutaneous angiomatosis, but hepatic lesions should improve after several months of therapy.

Peliosis Hepatis is an uncommon vascular condition characterised by randomly distributed multiple blood-filled cavities throughout the liver.

Bartonella species (cat-scratch disease, bacillary angiomatosis, bacillary peliosis).

Bacillary peliosis is a condition that most-often affects patients with HIV and other conditions causing severe immune compromise.

Osteomyelitis is usually caused by B. quintana, and only B. henselae can cause bacillary peliosis hepatis.

Peliosis hepatis is often erroneously written "peliosis hepatitis", despite its not being one of the hepatitides.

Peliosis hepatis caused by B. henselae can occur alone or develop with cutaneous bacillary angiomatosis or bacteremia.

CNS infections, bacillary peliosis, osteomyelitis, severe infections:

Bartonella henselae, formerly Rochalimæa, is a proteobacterium that can cause bacteremia, endocarditis, bacillary angiomatosis, and peliosis hepatis.

Bacillary peliosis is a form of peliosis hepatis that has been associated with bacteria in the genus Bartonella.

Patients with peliosis hepatis present with gastrointestinal symptoms, fever, chills, and an enlarged liver and spleen containing blood-filled cavities.

Bacillary peliosis is characterized by angiomatous masses in visceral organs; it mainly occurs in severely immunocompromised patients with HIV infection.

Bartonella species cause infections that include cat scratch disease, trench fever, relapsing bacteremia, endocarditis, bacillary angiomatosis (BA), and bacillary peliosis hepatis (506).

Bartonella cause diseases such as Carrión's disease, trench fever, cat-scratch disease, bacillary angiomatosis, peliosis hepatis, chronic bacteremia, endocarditis, chronic lymphadenopathy, and neurological disorders.

Peliosis hepatis can be associated by peliosis of the spleen, as well as bacillary angiomatosis of the skin in HIV patients.

Clinical manifestations of B. henselae and B. quintana specific to HIV-infected and other immunocompromised patients include bacillary angiomatosis and bacillary peliosis.

Bartonella henselae is the etiologic agent for peliosis hepatis, which is defined as a vascular proliferation of sinusoid hepatic capillaries resulting in blood-filled spaces in the liver.

Bartonella henselae can be associated with bacteremia, bacillary angiomatosis, and peliosis hepatis in HIV patients, and bacteremia and endocarditis in immunocompetent and immunocompromised patients.

In cases of bacillary angiomatosis and bacillary peliosis, diagnosis is usually made through biopsy with a characteristic histologic picture: clusters of organisms can be demonstrated with Warthin-Starry silver stain of affected tissue.

Erythromycin and doxycycline have been used successfully to treat BA, peliosis hepatis, bacteremia, and osteomyelitis and are considered first-line treatment for bartonellosis, on the basis of reported experience in case series (AII) (506,507).

The organisms can be isolated with difficulty from blood or tissue culture using enriched agar; they have been isolated more successfully from specimens from patients with bacillary angiomatosis and peliosis than from patients with typical cat-scratch disease (107).

Therapy should be administered for 3 months for cutaneous bacillary angiomatosis and 4 months for bacillary peliosis, CNS disease, osteomyelitis, or severe infections, as treatment must be of sufficient duration to prevent relapse (AII) (104,123).