new_n_lost
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A 38-year-old AIDS patient presents to the clinic complaining of nausea, occasional vomiting and "bumps" on his groin. On physical examination, multiple, nontender, pedunculated reddish purple nodules in the inguinal and perirectal areas are observed. The patient's liver is palpable 8 cm below the right costal margin. Routine laboratory tests are unremarkable except for an alanine aminotransferase level of 58 and alkaline phosphatase of 90. He denies any foreign travel, but has two pet cats.
Which of the following is the most likely cause of this patient's infection?
A. Bartonella henselae
B. Human papillomavirus
C. Molluscum contagiosum virus
D. Rickettsia prowazekii
E. Treponema pallidum
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| SILVER
DoWhatYouGotToDo!
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A. Bartonella henselae
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| unique1
Biochemistry
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 A.
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| GoodGirl
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A
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Prioritize & simplify
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| tompat
Forum Elite
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wud opt for A.
lesions resemble kaposis sarcoma, but pt need not necessarily be immunocomprimised.
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| po
Forum Elite
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Hepatomegaly?-Physical findings relating to systemic involvement by BA may also be evident. Peliosis hepatis is a disease caused by Bartonella infection, which can manifest as nausea, vomiting, diarrhea, and fever with hepatosplenomegaly. Also, bone pain from a destructive bone mass may occur.
BA has been suggested to be caused with equal frequency by B henselae and B quintana. Infection with these tiny gram-negative bacilli that are difficult to culture results from exposure to flea-infested cats in B henselae infection and the human body louse in B quintana infection. B quintana can also cause bacteremia, urban trench fever, and endocarditis in immunocompetent persons. It is associated with lytic bone lesions. Peliosis hepatis and lymph node involvement are linked with B henselae.
BA often responds to therapy with oral erythromycin, although other oral antibiotics and antituberculosis medications, including tetracycline, trimethoprim-sulfamethoxazole, and rifampin, may also be effective. While BA is treatable and curable, it may be life threatening if untreated.
http://www.emedicine.com/derm/topic44.htm
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