Hyperechogenic hepatic lesions in an AIDS patient with bacillary angiomatosis

The diagnosis of opportunistic infections due to uncommon pathogens is still a challenge in AIDS patients, in spite of introduction of HAART. Bacillary Angiomatosis (BA) is a rare, perhaps under-diagnosed, and potentially treatable opportunistic infection in immunocompromised patients. We describe a case of BA with hepatic peliosis as the first manifestation of AIDS in a patient who was contemporarily diagnosed to be HIV-positive, with severe immune- depression, diffuse cutaneous nodules on the trunk, back and arms highly suggestive for BA at histology, and cerebral lesions on MRI. Antibodies against Bartonella…