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. 2024 Apr 8;24(1):380.
doi: 10.1186/s12879-024-09253-9.

A systematic review on antibiotic therapy of cutaneous bacillary angiomatosis not related to major immunocompromising conditions: from pathogenesis to treatment

Salvatore Rotundo  1 , Maria Teresa Tassone  1 , Nadia Marascio  2 , Helen Linda Morrone  1 , Simona Gigliotti  2 , Angela Quirino  2 , Alessandro Russo  1   3 , Giovanni Matera  2 , Enrico Maria Trecarichi  1   3 , Carlo Torti  4   5
Affiliations

A systematic review on antibiotic therapy of cutaneous bacillary angiomatosis not related to major immunocompromising conditions: from pathogenesis to treatment

Salvatore Rotundo et al. BMC Infect Dis. .

Abstract

Background: Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella spp. that mostly affects people living with HIV (PLWH), transplanted patients and those taking immunosuppressive drugs. Since cBA is mostly related to these major immunocompromising conditions (i.e., T-cell count impairment), it is considered rare in relatively immunocompetent patients and could be underdiagnosed in them. Moreover, antimicrobial treatment in this population has not been previously investigated.

Methods: We searched the databases PubMed, Google Scholar, Scopus, OpenAIRE and ScienceDirect by screening articles whose title included the keywords "bacillary" AND "angiomatosis" and included case reports about patients not suffering from major immunocompromising conditions to provide insights about antibiotic treatments and their duration.

Results: Twenty-two cases of cBA not related to major immunocompromising conditions were retrieved. Antibiotic treatment duration was shorter in patients with single cBA lesion than in patients with multiple lesions, including in most cases macrolides and tetracyclines.

Conclusions: cBA is an emerging manifestation of Bartonella spp. infection in people not suffering from major immunocompromising conditions. Until evidence-based guidelines are available, molecular tests together with severity and extension of the disease can be useful to personalize the type of treatment and its duration.

Keywords: Bartonella; Antibiotic; Bacillary angiomatosis; Emerging disease; One health; PCR.

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Conflict of interest statement

The authors declare that they have no competing interests.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of study selection process
Fig. 2
Fig. 2
Type and duration of antibiotic treatment in single (a) and in multiple (b) cutaneous bacillary angiomatosis (cBA) lesions
Fig. 3
Fig. 3
Comparison of duration of antibiotic therapy between single and multiple cutaneous bacillary angiomatosis. Statistical analysis was performed by GraphPad Prism 9.0 Version 9.3.1 (GraphPad Software, San Diego, CA 92,108), and the data are expressed as median ± interquartile range. Mann-Whitney test was applied to analyze duration of antibiotic therapy in the two groups. Exact duration of antibiotic therapy in patients reported by Tappero JW et al. [22] was not specified and ranged from four to six weeks. The maximum duration of antibiotic therapy (six weeks) was considered for this analysis
See this image and copyright information in PMC

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