Monday, June 1, 2009


I know this is a hard picture to see but we're looking at that nodular red-purple skin lesion in this gentleman. He presented to his primary care physician complaining of fever, chills, malaise, headache, anorexia, and weight loss. Concerned about these constitutional symptoms, the primary care doctor sent off a bunch of labs and found that the patient was HIV positive with CD4 count 95 cells/mm3. He was then referred to you for this odd skin lesion.

These lesions typically first develop as small red to purple papules that can expand to large pedunculated lesions or nodules that may be friable. Though the surface starts off smooth, it can erode and ulcerate. Trauma may cause lesions to bleed profusely. This is the only lesion noted on this gentleman.

Challenge: Well, you think, this is probably Kaposi's sarcoma, until the primary care doctor calls you and says the blood cultures came back positive with what organism? (Meow)

Image is shown under fair use.


tree said...

Bacillary angiomatosis, caused by Bartonella

Dr. Yahya said...

Bartonella Infection!!!! But believe it or not, it is a rather hard case.

Stephanie said...

bartonella henselae

Alex said...

CSD bacillary angiomatosis

Craig Chen said...

Wow!!! Nice job guys, that one was hard :) Maybe I shouldn't have said meow :P

This is bacillary angiomatosis, caused by a Bartonella infection in an HIV-infected patient (the etiology of cat-scratch disease, giving the title of this case).

Sources: UpToDate;