A patient who is a known case of AIDS presents to the OPD with fever, chills, malaise and weight loss. The microscopic examination of the cutaneous lesion shown below revealed predominant neutrophilic infiltration. What is the most likely diagnosis?
Correct Answer: Bacillary angiomatosis
Description: The clinical vignette and the microscopic findings suggest the diagnosis of bacillary angiomatosis. Bacillary angiomatosis is a disease of severely immunocompromised patients, is caused by B. henselae or B. quintana, and is characterized by neovascular proliferative lesions involving the skin. It consists of lobular proliferations of small blood vessels lined by enlarged endothelial cells interspersed with mixed infiltrates of neutrophils and lymphocytes, with predominance of the former. Both bacillary angiomatosis and Kaposi&;s sarcoma can have clinical presentation as mentioned in the question. However, the major differentiating factor is the microscopic examination. While bacillary angiomatosis predominantly have mixed infiltrate accompanied by neutrophils with clumps of bacilli ,whereas Kaposi&;s sarcoma predominantly has plasma cells Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition
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Microbiology
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