Tappero J W, Perkins B A, Wenger J D, Berger T G
Childhood and Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Clin Microbiol Rev. 1995 Jul;8(3):440-50. doi: 10.1128/CMR.8.3.440.
Bacillary angiomatosis (BA) presents most commonly as a cutaneous disease and is caused by two organisms. Bartonella (Rochalimaea) henselae and Bartonella (Rochalimaea) quintana. Biopsy confirmation of cutaneous BA is essential because lesions can mimic nodular Kaposi's sarcoma in appearance. Although the vast majority of human immunodeficiency virus (HIV)-infected patients with BA have CD4 lymphocyte counts of less than 100 cells per mm3, the disease responds well to antimicrobial therapy. Staphylococcus aureus is the most common bacterial skin pathogen affecting HIV-infected patients. The prevalence of skin disease due to S. aureus may be explained by high nasal carriage rates for the organism ( > or = 50%) and altered immune function in conjunction with an impaired cutaneous barrier. Herpes simplex virus causes mucocutaneous disease early in the course HIV infection and ulcerative lesions at any site in advanced HIV infection. Herpes zoster is common early in the course of HIV infection; recurrent and disseminated herpes zoster infections are characteristic of patients with advanced HIV disease. Acyclovir resistance is usually seen in patients with large, untreated, ulcerative lesions of herpes simplex virus and in patients with chronic, verrucous lesions of varicella-zoster virus. Cutaneous cryptococcosis, histoplasmosis, and coccidiomycosis are markers of disseminated disease and require biopsy confirmation. Scabies is easily diagnosed but may be atypical in presentation and difficult to eradicate in advanced HIV disease.
杆菌性血管瘤病（BA）最常表现为一种皮肤疾病，由两种病原体引起，即汉赛巴尔通体（罗卡利马体）和五日热巴尔通体（罗卡利马体）。皮肤BA的活检确诊至关重要，因为其皮损外观可酷似结节性卡波西肉瘤。尽管绝大多数患BA的人类免疫缺陷病毒（HIV）感染患者的CD4淋巴细胞计数低于每立方毫米100个细胞，但该疾病对抗菌治疗反应良好。金黄色葡萄球菌是影响HIV感染患者的最常见细菌性皮肤病原体。由金黄色葡萄球菌引起的皮肤疾病患病率高，可能是因为该菌鼻腔携带率高（≥50%），以及免疫功能改变与皮肤屏障受损共同作用的结果。单纯疱疹病毒在HIV感染病程早期引起皮肤黏膜疾病，在晚期HIV感染时可在任何部位引起溃疡性病变。带状疱疹在HIV感染病程早期很常见；复发性和播散性带状疱疹感染是晚期HIV疾病患者的特征。单纯疱疹病毒的大片未治疗溃疡性病变患者以及水痘 - 带状疱疹病毒慢性疣状病变患者通常可见阿昔洛韦耐药。皮肤隐球菌病、组织胞浆菌病和球孢子菌病是播散性疾病的标志，需要活检确诊。疥疮易于诊断，但在晚期HIV疾病中表现可能不典型且难以根除。
