The human immunodeficiency virus (HIV) epidemic has greatly increased the number of persons suffering opportunistic infections. Surprisingly, most opportunistic pathogens in HIV disease are those previously known to infect patients immunosuppressed for other reasons. A handful of "new" conditions has emerged from the HIV epidemic, including oral hairy leukoplakia, and, recently, bacillary angiomatosis.
Bacillary angiomatosis has no doubt been with us since before HIV disease (for examples, see below). During the years when AIDS was GRID, it lay camouflaged by the much more common opportunistic neoplasm Kaposi's sarcoma, which outnumbers it by perhaps 50:1 in incidence (personal observation). Credit for finding the needle of this new disease amidst the haystack of patients with Kaposi's sarcoma should go to Mark H. Stoler, MD, then a pathologist at the University of Rochester (NY), who observed bacteria within the subcutaneous lesions of a patient initially supposed to have Kaposi's sarcoma and noted the unusual staining characteristics of the bacilli.1 This observation enabled successful antibiotic treatment of the condition.