{"id":1031,"date":"2021-08-11T16:13:00","date_gmt":"2021-08-11T16:13:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=1031"},"modified":"2025-10-01T11:42:37","modified_gmt":"2025-10-01T19:42:37","slug":"usmle-step-1-question-of-the-day-bacillary-angiomatosis","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day: Bacillary Angiomatosis"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis\/#C_Bartonella_henselae\" >C.&nbsp;Bartonella henselae<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis\/#Incorrect_answer_explanations\" >Incorrect answer explanations<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis\/#A_Blastomycosis_dermatitis\" >A.&nbsp;Blastomycosis dermatitis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis\/#B_Human_herpesvirus_8\" >B.&nbsp;Human herpesvirus 8<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis\/#D_Yersinia_pestis\" >D.&nbsp;Yersinia pestis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis\/#E_Rickettsia_rickettsii\" >E.&nbsp;Rickettsia rickettsii<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case involves a 30-year-old woman with HIV who has recently developed skin nodules. The woman also works in a pet store. Can you figure it out?<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 30-year-old woman with&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/HIV_(AIDS)\" target=\"_blank\" rel=\"noreferrer noopener\">HIV<\/a>&nbsp;comes to the clinic due to the recent appearance of skin nodules and progressive fatigue and anorexia for the past 2 months. She recently moved to Ohio and started working in a pet store. She is currently not taking antiretroviral therapy, and her recent CD4 count one month ago was 80 cells\/mm3. Her temperature is 38.0\u00b0C (100.4\u00b0F), her pulse is 80\/min, and blood pressure is 125\/85 mmHg. Physical examination shows multiple small red-purple papules, some of which are pedunculated and some bleed. Histopathology of one of the lesions shows vascular proliferation with some clusters of neutrophils and lymphocytes. Which of the following is the most likely pathogen responsible for this patient\u2019s presentation?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Blastomycosis dermatitis<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Human herpesvirus 8<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Bartonella henselae<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Yersinia pestis<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Rickettsia rickettsii<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><br><\/strong>Scroll down to find the answer!<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Everybody loves Osmosis.org\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/kizbJZ9cdLg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><strong><em><a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\"><u><em><strong>\u2192 Reinforce your understanding with more self-assessment items on Osmosis.<\/strong>\u00a0<\/em><\/u><\/a><\/em><\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C_Bartonella_henselae\"><\/span>C.&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Bartonella_henselae_(Cat-scratch_disease_and_Bacilary_angiomatosis)\" target=\"_blank\" rel=\"noreferrer noopener\">Bartonella henselae<\/a><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the&nbsp;<strong>Main Explanation<\/strong>, let&#8217;s look at the incorrect answer explanations. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_answer_explanations\"><\/span>Incorrect answer explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The incorrect answers to today&#8217;s USMLE\u00ae Step 1 Question are&#8230;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Blastomycosis_dermatitis\"><\/span>A.&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Blastomycosis\" target=\"_blank\" rel=\"noreferrer noopener\">Blastomycosis dermatitis<\/a><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong><a href=\"https:\/\/www.osmosis.org\/learn\/Blastomycosis\" target=\"_blank\" rel=\"noreferrer noopener\">Blastomycosis dermatitis<\/a>&nbsp;is a systemic pyogranulomatous infection caused by inhalation of the spores of the dimorphic fungus, which is prevalent in North America. Pulmonary involvement is the most common manifestation, and patients may present with&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Pneumonia\" target=\"_blank\" rel=\"noreferrer noopener\">acute or chronic pneumonia<\/a>. Skin involvement is also common, and presents as gray to violet, verrucous skin lesions with an irregular border that may mimic&nbsp;squamous cell carcinoma. Biopsy from the margins typically shows broad-based budding organisms on microscopy. This patient\u2019s characteristic nodules, biopsy results, and the absence of pulmonary involvement favor another diagnosis.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"B_Human_herpesvirus_8\"><\/span>B.&nbsp;<a href=\"http:\/\/human%20herpesvirus%208%20(kaposi%20sarcoma)\/\" target=\"_blank\" rel=\"noreferrer noopener\">Human herpesvirus 8<\/a><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong><a href=\"http:\/\/human%20herpesvirus%208%20(kaposi%20sarcoma)\/\" target=\"_blank\" rel=\"noreferrer noopener\">Kaposi sarcoma (KS)<\/a>&nbsp;is an angioproliferative disorder caused by infection with human herpesvirus 8 (HSV-8), often seen in immunocompromised patients.<strong>&nbsp;<\/strong>KS can involve virtually any site in the body, however, cutaneous disease is most common. The lesions of KS can be pink, red, purple, or brown, and they tend to be elliptical, not painful or pruritic, and without necrosis. There are generally no associated constitutional symptoms. Additionally, histopathology analysis in KS will likely show whorls of spindle-shaped cells with lymphocytic infiltration, not neutrophilic infiltration, as well as proliferation of small vessels.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"D_Yersinia_pestis\"><\/span>D.&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Yersinia_pestis_(Plague)\" target=\"_blank\" rel=\"noreferrer noopener\">Yersinia pestis<\/a><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong><a href=\"https:\/\/www.osmosis.org\/learn\/Yersinia_pestis_(Plague)\" target=\"_blank\" rel=\"noreferrer noopener\">Yersinia pestis<\/a>&nbsp;is a zoonotic infection that causes plague. It is transmitted by bites from rodent fleas, scratches or bites from infected domestic cats, and inhalation of respiratory secretions from infected animals. The most common manifestation is acute febrile lymphadenitis (bubonic plague). It is characterized by the acute onset of fever, chills, weakness, and headache, followed by intense pain and swollen lymphadenopathy. Skin lesions may appear and include eschars, pustules, or lesions resembling ecthyma gangrenosum. This patient\u2019s presentation favors another diagnosis.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"E_Rickettsia_rickettsii\"><\/span>E.&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Rickettsia_rickettsii_(Rocky_Mountain_spotted_fever)_and_other_Rickettsia_species\" target=\"_blank\" rel=\"noreferrer noopener\">Rickettsia rickettsii<\/a><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong><a href=\"https:\/\/www.osmosis.org\/learn\/Rickettsia_rickettsii_(Rocky_Mountain_spotted_fever)_and_other_Rickettsia_species\" target=\"_blank\" rel=\"noreferrer noopener\">Rickettsia rickettsii<\/a>&nbsp;is a gram-negative, obligate intracellular bacterium that causes Rocky Mountain spotted fever, a tick-borne disease (Dermacentor dog tick). Patients often present with non-specific symptoms such as fever, headache, malaise, myalgias, and arthralgias followed by blanching erythematous rash with macules that later become petechial. This patient\u2019s presentation favors another diagnosis.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span><strong>Main Explanation<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This patient, who is presenting with&nbsp;<strong>fever<\/strong>,&nbsp;<strong>fatigue<\/strong>,&nbsp;<strong>anorexia,&nbsp;<\/strong>and characteristic&nbsp;<strong>skin lesions,<\/strong>&nbsp;most likely has&nbsp;<strong>bacillary angiomatosis<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.osmosis.org\/learn\/Bartonella_henselae_(Cat-scratch_disease_and_Bacilary_angiomatosis)\" target=\"_blank\" rel=\"noreferrer noopener\">Bacillary angiomatosis<\/a>&nbsp;is caused by&nbsp;<strong>Bartonella species<\/strong>, a fastidious, slow-growing, gram-negative bacillus. The natural reservoir is&nbsp;<strong>domestic cats<\/strong>&nbsp;and is transmitted to humans via&nbsp;<strong>scratch<\/strong>, bite, or exposure to cat feces\/fleas. Cat-scratch disease (CSD) usually affects immunocompetent children and presents as regional limited lymphadenopathy\/lymphadenitis.&nbsp;<strong>Immunodeficient<\/strong>&nbsp;individuals, however, are at risk for developing disseminated bacillary angiomatosis which usually occurs when CD4 count is less than 100 cells\/mm<sup>3<\/sup>.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Bartonella henselae - causes, symptoms, diagnosis, treatment, pathology\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/VUEGrqHuJeo?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Patients with bacillary angiomatosis often present with&nbsp;<strong>constitutional symptoms<\/strong>, including fever, chills, malaise, headache, anorexia, weight loss and unique vascular lesions. The skin is the most affected organ, but the lesions can occur throughout the body (e.g., bone, lymph nodes, GI). The lesions may start as red to purple papules which gradually expand into pedunculated lesions or nodules that become friable and bleed. Biopsy shows&nbsp;<strong>vascular proliferation<\/strong>&nbsp;with clusters of&nbsp;<strong>neutrophils<\/strong>&nbsp;and lymphocytes infiltrating. Diagnosis is challenging and usually requires a combination of tests including culture, PCR, biopsy, and staining with Warthin-Starry silver staining. Treatment consists of prolonged courses of either erythromycin or doxycycline.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span><strong>Major Takeaway<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/www.osmosis.org\/learn\/Bartonella_henselae_(Cat-scratch_disease_and_Bacilary_angiomatosis)\" target=\"_blank\" rel=\"noreferrer noopener\">Bacillary angiomatosis<\/a><\/strong>&nbsp;is caused by&nbsp;<strong>Bartonella species<\/strong>, a gram-negative bacilli transmitted to humans, most commonly via&nbsp;<strong>scratch&nbsp;<\/strong>from an infected cat. Immunodeficient individuals may present with fever, fatigue, anorexia, and characteristic pedunculated, vascular skin lesions.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span><strong>References<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Saccente M, Woods GL. Clinical and laboratory update on blastomycosis.&nbsp;<em>Clin Microbiol Rev<\/em>. 2010;23(2):367\u2010381.&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/20375357\/\" target=\"_blank\" rel=\"noreferrer noopener\">doi:10.1128\/CMR.00056-09<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Lodi S, Guiguet M, Costagliola D, et al. Kaposi sarcoma incidence and survival among HIV-infected homosexual men after HIV seroconversion.&nbsp;<em>J Natl Cancer Inst<\/em>. 2010;102(11):784\u2010792.&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/20442214\/\" target=\"_blank\" rel=\"noreferrer noopener\">doi:10.1093\/jnci\/djq134<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Prentice MB, Rahalison L. Plague.&nbsp;<em>Lancet<\/em>. 2007;369(9568):1196\u20101207.&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17416264\/\" target=\"_blank\" rel=\"noreferrer noopener\">doi:10.1016\/S0140-6736(07)60566-2<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">LeBoit PE, Berger TG, Egbert BM, Beckstead JH, Yen TS, Stoler MH. Bacillary angiomatosis.&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/2802010\/\" target=\"_blank\" rel=\"noreferrer noopener\">The histopathology and differential diagnosis of a pseudoneoplastic infection in patients with human immunodeficiency virus disease<\/a>.&nbsp;<em>Am J Surg Pathol<\/em>. 1989;13(11):909\u2010920.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Cotell SL, Noskin GA. Bacillary angiomatosis. Clinical and histologic features, diagnosis, and treatment.&nbsp;<em>Arch Intern Med<\/em>. 1994;154(5):524\u2010528.&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/8122945\/\" target=\"_blank\" rel=\"noreferrer noopener\">doi:10.1001\/archinte.154.5.524<\/a><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em><strong>_________________________<\/strong><br><br><strong>Want more USMLE\u00ae Step 1 practice questions? Try Osmosis today! Access your&nbsp;<a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a>&nbsp;and find out why millions of current and future clinicians and caregivers love learning with us.<\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-02T200211.279.png?w=700\" alt=\"1800 + fun bite-sized videos break down lectures in minutes. Try it free today.\" class=\"wp-image-711\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-02T200211.279.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-02T200211.279.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em><sub>The United States Medical Licensing Examination (USMLE\u00ae) is a joint program of the Federation of State Medical Boards (FSMB\u00ae) and National Board of Medical Examiners (NBME\u00ae). Osmosis is not affiliated with NBME nor FSMB.&nbsp;<\/sub><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case involves a 30-year-old woman with HIV who has recently developed skin nodules. The woman also works in a pet store. Can you figure it out? A 30-year-old woman with&nbsp;HIV&nbsp;comes to the clinic due to the recent [&hellip;]<\/p>\n","protected":false},"author":202,"featured_media":1032,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[27,20,1369,44],"tags":[],"class_list":["post-1031","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-step-1-questions","category-step-1"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 1 Question of the Day: Bacillary Angiomatosis - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 1 Question of the Day: Bacillary Angiomatosis - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case involves a 30-year-old woman with HIV who has recently developed skin nodules. The woman also works in a pet store. Can you figure it out? A 30-year-old woman with&nbsp;HIV&nbsp;comes to the clinic due to the recent [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis\" \/>\n<meta property=\"og:site_name\" content=\"Osmosis Blog\" \/>\n<meta property=\"article:published_time\" content=\"2021-08-11T16:13:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-10-01T19:42:37+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-bacillary-angiomatosis.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1081\" \/>\n\t<meta property=\"og:image:height\" content=\"1081\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Marina Horiates Kerekes, MD &amp; Team\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":[\"Article\",\"BlogPosting\"],\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bacillary-angiomatosis\"},\"author\":{\"name\":\"Marina Horiates Kerekes, MD &amp; 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What's the best next step in her management? Can you figure it out? 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