{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T19:36:49Z","timestamp":1758397009422,"version":"3.40.4"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>A 56-year-old Hispanic man with no significant medical problems presented with a 2-month history of a non-healing right forearm lesion that progressed despite several courses of empiric antibiotics. The patient underwent incision and drainage. Warthin-Starry stain with immunohistochemistry testing diagnosed bacillary angiomatosis secondary to<jats:italic>Bartonella quintana.<\/jats:italic>Subsequently, the patient was diagnosed with HIV, with a CD4 count of 68\u2005cells\/mm<jats:sup>3<\/jats:sup>, and a HIV viral load of 47, 914\u2005copies\/mL. The patient was treated with doxycycline and started on antiretroviral therapy. 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