Soft-tissue and osseous lesions caused by bacillary angiomatosis: unusual manifestations of cat-scratch fever in patients with AIDS.

Abstract

Cat-scratch disease, caused by a pleomorphic Gram-negative rod known as the cat-scratch bacillus, has many rare and varied complications and unusual manifestations [1]. Recent reports [2-6] have described bacillary angiomatosis as a new manifestation of systemic cat-scratch disease seen in patients with AIDS who have cutaneous lesions, subcutaneous nodules, or osteolytic lesions. We report a case of bacillary angiomatosis that was manifested as a vascular softtissue mass in which cat-scratch bacilli were shown by electron microscopy. To our knowledge, no similar cases of softtissue masses in systemic cat-scratch disease have been reported. As our case illustrates, systemic cat-scratch disease has clinical and radiologic features that resemble both benign and malignant diseases. Although certain radiologic and dinical findings may suggest the diagnosis of systemic catscratch disease, a definitive diagnosis is made only on the basis of biopsy specimens examined by using either special stains or electron microscopy.