Has anyone ever heard of a Bartonella rash which is blistered?
I'm currently in treatment for Bartonella. I had four roundish red lesions appear on the inside of my leg, near my crotch. They look like blisters without any fluid in them. They're about 1/4" to 1/2" in diameter and clustered together.
Does this sound familiar for a Bart rash?
Posted by savebabe (Member # 9847) on :
up
Posted by disturbedme (Member # 12346) on :
I know that having pastule-looking things come up is Bart, so yes, this sounds like a Bart herx.
I had ONE on my back/hip a couple months back. Though haven't noticed anymore since and I have Bart.
Posted by Tincup (Member # 5829) on :
The overlying epidermis may demonstrate atrophy, ulceration, or at times, pseudoepitheliomatous hyperplasia. An epithelial collarette may be observed, particularly in those BA nodules that clinically resemble pyogenic granuloma. The dermis shows a vascular proliferation with small vessels arranged in clusters around ectatic vessels that may be markedly dilated. A lobular pattern may be observed, with varying amounts of edema and mucinous or fibrotic change between the lobules. Protuberant cuboidal endothelial cells line the blood vessel lobules.
This lobulation is accentuated with a reticulum stain. Little or no atypia is usually observed, although marked atypia of endothelial nuclei has been described with solid-appearing areas of endothelial cells having many mitotic figures and necrosis.
Some BA lesions have 2 distinct regions of vascular proliferation, a superficial one resembling a pyogenic granuloma or a papular angiokeratoma and a deeper one similar to a histiocytoid hemangioma with a proliferation of small blood vessels lined by protuberant endothelial cells closely adherent to one another in an epithelioid pattern.
The presence of neutrophils adjacent to the blood vessels is noteworthy and may be an important clue to this diagnosis. Granular material resembling fibrin may be beside the neutrophils. This is the bacterium, observed best with either Warthin-Starry silver or Grocott-silver methenamine stain.
A similar histologic pattern may be evident in affected oral mucosa, lymph nodes, liver, spleen, bone marrow, larynx, gastrointestinal tract, peritoneum, diaphragm, and bronchial mucosa.
Some lesions have only a few solitary neutrophils and moderate numbers of bacteria, whereas others have clusters of neutrophils and numerous nearby bacteria, in some cases to the extent of mimicking a frank abscess.
Some BA nodules may histologically resemble those of histiocytoid (epithelioid) hemangioma, Kaposi sarcoma, and verruga peruana (bartonellosis). A proliferation of both endothelial cells and factor XIIIa-positive dermal dendrocytes is observed in BA, verruga peruana, granuloma pyogenicum, and Kaposi sarcoma.
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If that is clear as mud... try this... which they can look like.
![[Big Grin]](biggrin.gif)