B

Bagassosis (See "Pneumoconiosis.") Barbiturate(s) (See "Poisoning, barbiturate(s).") Baritosis (See "Pneumoconiosis.") Bartonellosis

Synonyms and Related Terms: Bacillary angiomatosis (1); Bartonella bacilliformis, henselae, or quintana infection; Carrion's disease; cat scratch disease (1);* Oroya fever; Peruvian anemia; verruga peruana.

Organs and Tissues Procedures

External examination and skin

Blood

Blood and lymphatic vessels (all organs and lesions)

Heart

Liver and spleen

Lymph nodes Bone marrow

1. Wong R, Tappero J, Cockerell CJ. Bacillary angiomatosis and other Bartonella species infections. Semin Cutan Med Surg 1997;16:188-199.

2. Goldenberger D, Zbinden R, Perschil I, Altwegg M. Nachweis von Bartonella (Rochalimaea) henselae/B. quintana mittels Polymerase-Kettenreaktion (PCR). Schweiz Med Wschr 1996;126:207-213.

From: Handbook of Autopsy Practice, 3rd Ed. Edited by: J. Ludwig © Press Inc., Totowa, NJ

NOTE: (1) Collect all tissues that appear to be infected. (2) Organisms are usually demonstrated by direct stains rather than by culture. Detection by polymerase chain reaction (PCR) is possible (2). (3) Request Giemsa stains (p. 172). (4) No special precautions are indicated. (5) Serologic studies are available from the Center for Disease Control and Prevention, Atlanta GA (p. 135). (6) This is a reportable disease.

Possible Associated Conditions: Acquired immunodeficiency syndrome (AIDS)* and other immunodeficiency states (3); hemolytic anemia;* Salmonella infection.

Possible or Expected Findings

Prepare sections of skin lesions. Request Giemsa stain (p. 172).

Prepare smears. Request Giemsa stain (p. 172). Request Giemsa stain (p. 172).

For demonstration of fat, prepare frozen section of myocardium with Sudan IV stain. Record weights. Submit samples for histologic study and request Giemsa and Gomori iron stains (p. 172).

See above under "Liver and Spleen." See above under "Liver and Spleen."

Jaundice. Miliary and nodular skin lesions with or without ulceration. Histologically, pigmented (hemosiderin) vascular granulomas. Bacillary angiomatosis (1). Bartonella in erythrocytes. Bartonella bacilliformis in swollen reticuloendothelial cells lining blood and lymphatic vessels. Thromboses. Erythrophagocytosis. Fatty changes of myocardium in anemic patients.

Centrilobular hepatic necrosis; bacillary peliosis hepatis and bacillary splenitis; granulomatous hepatitis (3); hemosiderosis of liver and spleen. Erythrophagocytosis; thromboses; necrosis (3); and infarcts of spleen.

Lymphadenopathy (see above under "Blood and lymphatic vessels"). Erythroid hyperplasia.

References

3. Liston TE, Koehler JE. Granulomatous hepatitis and necrotizing splenitis due to Bartonella henselae in a patient with cancer: case report and review of hepatosplenic manifestations of bartonella infections. Clin Infect Dis 1996;22:951-957.

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