Bartonella, a gram-negative bacterium, causes various clinical syndromes such as cat scratch disease (B henselae), Carrion disease (B bacilliformis), and trench fever (B quintana). Given the pathogenicity, it is imperative to understand the diverse manifestations of each disease for early diagnosis and treatment. In the literature, B henselae has been described to cause lytic bone lesions, especially in children. However, it is rare for B quintana to cause bony lesions, especially in adults. We describe a case of disseminated B quintana in a male patient with AIDS who presented with bacillary angiomatosis, hepatic peliosis, and innumerable lytic lesions.