Bacillary Angiomatosis and Bacillary Peliosis in Patients Infected with Human Immunodeficiency Virus: Clinical Characteristics in a Case-Control Study
1996; Oxford University Press; Volume: 22; Issue: 5 Linguagem: Inglês
10.1093/clinids/22.5.794
ISSN1537-6591
AutoresJanet C. Mohle‐Boetani, Jane E. Koehler, T G Berger, Philip E. LeBoit, Carol A. Kemper, Arthur Reingold, Brian D. Plikaytis, Jay D. Wenger, Jordan W. Tappero,
Tópico(s)Rabies epidemiology and control
ResumoClinical characteristics associated with bacillary angiomatosis and bacillary peliosis (BAP) in patients with human immunodeficiency virus (HIV) infection were evaluated in a case-control study; 42 case-patients and 84 controls were matched by clinical care institution. Case-patients presented with fever (temperature, >37.8°C; 93%), a median CD4 lymphocyte count of 21/mm3 , cutaneous or subcutaneous vascular lesions (55%), lymphadenopathy (21%), and/or abdominal symptoms (24%). Many case-patients experienced long delays between medical evaluation and diagnosis of BAP (median, 4 weeks; range, 1 day to 24 months). Case-patients were more likely than controls to have fever, lymphadenopathy, hepatomegaly, splenomegaly, a low CD4 lymphocyte count, anemia, or an elevated serum level of alkaline phosphatase (AP) (P < .001). In multivariate analysis, a CD4 lymphocyte count of <200/mm3 (matched odds ratio [OR], 9.9; P < .09), anemia reflected by a hematocrit value of <0.36 (OR, 19.7;P < .04), and an elevated AP level of ⩾2.6 µkat/L (OR, 23.9; P < .05) remained associated with disease after therapy with zidovudine was controUed for. BAP should be considered an AIDS-defining opportunistic infection and should be included in the differential diagnosis for febrile, HIV-infected patients with cutaneous or osteolytic lesions, lymphadenopathy, abdominal symptoms, anemia, or an elevated serum level of AP.
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