Isolation of Rochalimaea species from cutaneous and osseous lesions of bacillary angiomatosis

N Engl J Med. 1992 Dec 3;327(23):1625-31. doi: 10.1056/NEJM199212033272303.


Background: Bacillary angiomatosis is characterized by vascular lesions, which occur usually in patients infected with the human immunodeficiency virus (HIV). A newly described gram-negative organism, Rochalimaea henselae, has been associated with cutaneous bacillary angiomatosis, but no organism has been isolated and cultivated directly from cutaneous tissue.

Methods: We used two methods to isolate the infecting bacterium from four HIV-infected patients with cutaneous lesions suggestive of bacillary angiomatosis: cultivation with eukaryotic tissue-culture monolayers and direct plating of homogenized tissue onto agar. The patients' blood was cultured with the lysis-centrifugation method. Isolates recovered from skin and blood were identified by sequencing all or part of the 16S ribosomal RNA gene amplified with the polymerase chain reaction.

Results: R. quintana, historically known as the agent of trench fever, was isolated from cutaneous lesions in three patients, after tissue homogenates were cultivated with endothelial-cell monolayers; R. henselae was isolated from a cutaneous lesion in one patient. In two patients, R. quintana was isolated from both cutaneous tissue and blood; in one patient it was also isolated from bone.

Conclusions: In bacillary angiomatosis, either of two species of rochalimaea--R. quintana or R. henselae--can be isolated from cutaneous lesions or blood, providing an additional method of diagnosis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • AIDS-Related Opportunistic Infections / microbiology*
  • Adult
  • Angiomatosis, Bacillary / microbiology*
  • Base Sequence
  • Blood / microbiology
  • Bone and Bones / microbiology*
  • Cells, Cultured
  • Humans
  • Male
  • Middle Aged
  • Molecular Sequence Data
  • Polymerase Chain Reaction
  • Rickettsiaceae / isolation & purification*
  • Rickettsiaceae Infections / microbiology*
  • Skin / microbiology*