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| | HIV and Bartonella: Bacillary Angiomatosis and Peliosis |
 | | BA occurs most frequently in the later stages of HIV infection; in one study of 42 patients, the median CD4+ cell count was 21 per cubic millimeter (range: 1-228) at the time of diagnosis of BA.(48) In this case-control study, patients with BA infection presented with fever (9%), lymphadenopathy (21%), and/or abdominal symptoms (24%). |
 | | Additionally, Bartonella bacteremia occurs in the apparent absence of localized tissue infection.(21,23,75) Of two HIV-infected patients,(21) one was later found to have hepatic BP by retrospective analysis of a percutaneous liver biopsy with Warthin-Starry staining.(67) The majority of bacteremic patients had fever, chills, and weight loss that resolved after antibiotic therapy. |
 | | Detection of Bartonella DNA in tissue specimens has been used to diagnose osseous(26) and cutaneous BA(2,18,26,42) and BP of the spleen(2,18) and liver.(42,82) This PCR technique is not commercially available but has important applications in several settings. |
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