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Case Reports
. 2017 Jul/Aug;16(4):321-323.
doi: 10.1177/2325957417702484. Epub 2017 Apr 10.

The First Report of Bartonella quintana Immune Reconstitution Inflammatory Syndrome Complicated by Jarisch-Herxheimer Reaction

Michelle DallaPiazza  1 , Matthew Jiro Akiyama  2
Affiliations
Case Reports

The First Report of Bartonella quintana Immune Reconstitution Inflammatory Syndrome Complicated by Jarisch-Herxheimer Reaction

Michelle DallaPiazza et al. J Int Assoc Provid AIDS Care. 2017 Jul/Aug.

Abstract

Bacillary angiomatosis (BA) is a rare complication of human immune deficiency virus (HIV) infection in the post-antiretroviral therapy (ART) era, and few cases of BA-associated immune reconstitution inflammatory syndrome (IRIS) have been described. We report the case of a 50-year-old man who presented with mass lesions involving the skin, subcutaneous tissues, muscle, and bone. The diagnosis of Bartonella quintana BA was confirmed by serum polymerase chain reaction. The patient's treatment course was complicated by both IRIS and Jarisch-Herxheimer reaction. The case had a favorable outcome with supportive care and continuation of ART and doxycycline.

Keywords: Bartonella quintana; HIV; Jarisch-Herxheimer reaction; bacillary angiomatosis; immune reconstitution inflammatory syndrome.

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Conflict of interest statement

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Biopsy of left thigh mass showing vascular proliferation with reactive and plump endothelium (black arrow) in a background of neutrophilic and lymphoplasmacytic infiltrate (white arrow).
Figure 2
Figure 2
A, Left lateral knee mass. B, Left thigh subcutaneous nodule.
See this image and copyright information in PMC

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