Bacillary angiomatosis and bacillary splenitis in immunocompetent adults.

Bacillary angiomatosis and parenchymal bacillary peliosis are recently described vascular disorders associated with infection by Rochalimaea henselae and Rochalimaea quintana, which occur in patients with either human immunodeficiency virus (HIV) infection or druginduced immune suppression (1-5). In addition, R. henselae and R. quintana (also the agent of trench fever) are both members of the family Rickettsiaceae (1, 4, 5), and infections due to Rochalimaea species have been associated with exposure both to cats (2) and to arthropod vectors (1, 5). We describe five patients with cutaneous bacillary angiomatosis or bacillary splenitis without evidence of HIV infection who were determined to be immunocompetent after immunologic evaluation. In three patients with both cat and cat flea exposures, infection by R. henselae was confirmed by amplification and sequencing of 16S rDNA from an infected tissue specimen.