Evidence map›Paper›PMID 24718378›Full record

ArticleJournal of the International Association of Providers of AIDS Care

Bacillary angiomatosis masquerading as Kaposi's sarcoma in East Africa.

A K Forrestel, A Naujokas, J N Martin, T A Maurer, T H McCalmont, M O Laker-Opwonya, G Mulyowa, N Busakhala, Erin H Amerson

Open access · goldAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the International Association of Providers of AIDS Care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.9field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 19 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Kaposi sarcoma.Nature reviews. Disease primers · 2019
    Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 3 countries.

A K ForrestelYale University School of Medicine, New Haven, CT, USA.
A NaujokasDepartment of Pathology, University of California, San Francisco, San Francisco, CA, USA.
J N MartinDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
T A MaurerDepartment of Dermatology, University of California, San Francisco, San Francisco, CA, USA.
T H McCalmontDepartment of Pathology, University of California, San Francisco, San Francisco, CA, USA.
M O Laker-OpwonyaDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA Infectious Diseases Institute, Kampala, Uganda.
G MulyowaSkin Clinic, Mbarara University of Science and Technology, Mbarara, Uganda.
N BusakhalaMoi University School of Medicine, Eldoret, Kenya.
Erin H AmersonDepartment of Dermatology, University of California, San Francisco, San Francisco, CA, USA amersone@derm.ucsf.edu.
University of California, San Francisco · USInfectious Diseases Institute · UGMbarara University of Science and Technology · UGMoi University · KEYale University · US

Funding

Virology CoreP30AI027763 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI STEVEN Grant DEEKS · 1988 to 2026
$93.6M
East Africa International Epidemiology Database to evaluate AIDS (IeDEA) Regional ConsortiumU01AI069911 · NIAID · INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS · PI AGGREY SEMWENDERO SEMEERE, Kara Kay Wools-Kaloustian · 2006 to 2026
$57.7M
Why do Patients Develop KSU54CA190153 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KAMBUGU, ANDREW DDUNGU, MARTIN, JEFFREY N · 2014 to 2019
$3.6M
Uganda-UCSF Research Training in HIV-Associated MalignanciesD43CA153717 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MARTIN, JEFFREY N · 2010 to 2013
$1.9M
Antiretroviral Therapy of AIDS-Related Kaposi's Sarcoma in AfricaR01CA119903 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MARTIN, JEFFREY N · 2005 to 2009
$1.9M
NCI NIH HHS D43 CA153717NCI NIH HHS R01 CA119903NCI NIH HHS U54 CA190153NIAID NIH HHS P30 AI027763NIAID NIH HHS U01 AI069911
6 · The paper itself

Abstract

backgroundBacillary angiomatosis (BA) is a rare manifestation of infection caused by Bartonella species, which leads to vasoproliferative lesions of skin and other organs. Bacillary angiomatosis affects individuals with advanced HIV disease or other immunocompromised individuals. In sub-Saharan Africa, despite the high prevalence of HIV infection and documentation of the causative Bartonella species in humans, mammalian hosts, and arthropod vectors, BA has only rarely been described.

methodsThree adult patients from Uganda and Kenya with deep purple dome-shaped papules or nodules of the skin underwent punch biopsies for histopathologic diagnosis. The biopsies of all 3 patients were sent to a local pathologist as well as to a dermatopathologist at the University of California, San Francisco.

resultsAll 3 patients were clinically suspected to have Kaposi's sarcoma (KS), and local pathologists had interpreted the lesions as KS in 2 of the cases and nonspecific inflammation in the third. Histologic examination by dermatopathologists in the United States revealed nodular dermal proliferations of irregular capillaries lined by spindled to epithelioid endothelial cells. The surrounding stroma contained a mixed inflammatory infiltrate with lymphocytes, eosinophils, and neutrophils. Extracellular deposits of pale amphophilic granular material were noted in the surrounding stroma. A Warthin-Starry stain highlighted clumps of bacilli, confirming the diagnosis of BA.

conclusionsThese 3 cases, to our knowledge, are the first reports of BA in East Africa in the biomedical literature. Each had been originally incorrectly diagnosed as KS. We speculate BA is underdiagnosed and underreported in resource-poor regions, such as sub-Saharan Africa, that have high endemic rates of HIV infection.

Indexed as

AIDS-Related Opportunistic InfectionsAngiomatosis, BacillaryAdultArmCheekDiagnosis, DifferentialFatal OutcomeFemaleFingersHumansSarcoma, KaposiYoung AdultAfricabacillary angiomatosisdermatologyHIVKaposi’s sarcoma

Identifiers

PMID24718378
PMCPMC4492938
OpenAlexW1974623249

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.