What is bacillary peliosis hepatis (BPH)?
BPH produces multiple cystic blood-filled spaces in the liver. BPH is caused by an infection with the bacteria Bartonella henselae (formerly Rochalimae ) and occurs in patients with advanced AIDS. Patients present with generalized and nonspecific symptoms, such as fever, weight loss, and malaise. Abdominal pain, nausea, vomiting, and diarrhea may be prominent. Skin manifestations include reddish vascular papules that can be confused with KS. On abdominal examination, hepatosplenomegaly and lymphadenopathy are the most prominent features. Histopathologic examination of the liver lesions shows multiple cystic blood-filled spaces within fibromyxoid areas. The treatment of choice is erythromycin for at least 4 to 6 weeks, but doxycycline is a safe alternative.