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#bartonella
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Bartonella henselae
Case Report:
23M veterinary student from home with a cat, presents with a one year history of neck swelling, 1 month of fevers and lethargy. Also he lives in Karachi.
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The fevers are a/w chills and rigours that response to paracetamol and have no particular pattern to them.
He doesnt have any arthralgias or arthritis or rash.
They find pretty sizable lymph nodes on exam in the cervical chain and inguinal regions.
He starts developing hypotension and they start him on some vasopressors and meropenem.
The fevers don't respond, and someone decides to start azithromycin, which it does respond to.
He's also worked up for IE given the chronicity of events.
Eventually on biopsy of the lymph node, the lab finds bartonella hensalae.
Microbiology + transmission:
aka cat scratch fever, so this is why history is so important to infectious diseases physicians.
it's actually disease of cats that can spread to their humans via bites and scratches. Or the cat licks a wound etc.
and unfortunately also via arthropod vectors and mossies
after entry into a host, it's main target cells are CD34s, immune cells, and then alters the host immune system
it's interesting special power is that it can predispose hosts to other pathogens in this manner
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it's a gram negative rod (pink rods)
Historical trivia
the fun bits
genus of Bartonella is named for a Peruvian scientist (Alberto Barton, also had interest in brucellosis and leishmaniasis --> other tropical diseases taht cause fevers of unclear origin), he isolated the bacteria from patients during an outbreak among railway works in South america. This was 1905.
reminds me of love in the time of cholera, when people still wrote physical letters.
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species of bartonella henselae is actually named for Diane Henselae, a researcher from Oklahoma, who collected samples during an outbreak there in the mid 1980s.
rare for someone who discovered a species named for them to be both alive and a woman, and I can't find much about her online.
there are other bartonella species that cause historically significant diseases like trench foot (bartonella quintana, transmitted by lice) and carrion's disease (bartonella bacilliformis, with a high mortality rate). another post for another day.
Clinical features
incubation period: up to 10 days
initial: rash at site of injection or intro of pathogen, from there it travels to local lymph nodes causing lymphadenopathy about 1-3 weeks later
From CDC guidelines who took image from NEJM
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Bsymptoms - low grade fevers/malaise/fatigue
epidemio: occurs most often (for a rare disease) in kids < 15
Complications
infection affecting the eye (neuro-retinitis = visual changes, irritation and photophobia), liver, spleen, brain/spine (transverse myelitis, encephalitis etc), bones and heart valves (IE)
Increased risk groups for complications
HIV/AIDs, immunocompromised hosts (i.e. transplants), mortality is an issue in this group, as disseminated disease a possibility
small risk of IE in groups with RFs for develop this (prosthetic valves, damaged valves, unrepaired congential heart disease etc)
Investigations
challenging, no gold standard test as the sens and spec is variable for each individual one, so it's a combination really, of history exam and a variety of confirmatory tests
PCR (variable spec/sens), serology (indirect and often negative in early stages, can also be positive for years post treatment and doesn't differentiate from other bartonella species), cultures are definitive but it can take 21 days for anything to grow (it's fastidious)
histopath of lymph nodes helpful - stains: silver stain or Warthin Starry stain (silver nitrate) which is kind of a reverse starry starry night used for spirochetes like helicobacter.
in IE, it can be culture negative, which can confuse diagnosis
From Wiki
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Management
mild disease is self resolving
first line: few days azithromycin or doxycycline can reduce symptoms and is indicated for enlarged lymph nodes to reduce size or unresolving LAD >1 month
in case of eye infection or IE expect longer duration of hterapy, like doxy and rif for 4-6 weeks
will also respond to bactrim, cipro, rif and gent
Prevention from the CDC:
avoid strays, wash hands after petting cats, keep strays from your cat, avoid owning new kittens who are < 1 yr if you are immunocompromised
avoid getting scratched..which is kinda hilarious but can see why
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Sources
stat pearls
case report above
wikipaedia
Rare diseases
CDC guidelines
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yaminahsaini · 3 months
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J’avais re eu une consultation avec le docteur qui m’avait prescrit la prise de sang pour re contrôler Bartonella etc…Je vais donc vous résumer le rdv et les résultats. Tout d’abord mes globules blanc affichent quasi à chaque fois qu’ils sont élevés depuis toujours.. Ça prouve juste que mon corps lutte constamment contre des infections. Ensuite j’ai des anticorps antinucléaires ultra élevés (encore plus que la dernière fois). Le docteur m’a dit que ça montre une maladie auto-immune (du coup les anticorps m’attaquent moi au lieu de me défendre). Et elle m’a dit qu’on ne pouvait rien faire face à cela mise à part supprimer totalement le lait de vache et le gluten. D’ailleurs durant le rdv on a recontacté la diététicienne pour voir où en est le fait d’avoir de nouvelles poches de nutritions, et ça avance enfin! Je vous expliquerais dans une prochaine publication. Pour continuer avec les résultats, j’ai plusieurs carences. Elle m’a donc prescrit : du zinc, du fer et de la vitamine D à prendre tous les jours. Je suis également en manque de protéines mais ça j’en aurais plus avec les nouvelles poches de nutrition. Arrive désormais le plus important ! Les résultats de la Bartonella! Le docteur était tout autant surprise que moi de voir que je suis négatif ! Alors que j’étais extrêmement positif à la Bartonellose (aux IgG et IgM), et là plus rien! Au début le docteur m’avait dit que ça ne voulait rien dire car ça peut être un faux négatif étant donné que lorsque le système immunitaire est trop faible, la bactérie peut se cacher (surtout bartonella qui s’adapte très bien). Et surtout, même en étant négatif, je dois au moins avoir les anticorps qui apparaissent! Mais là aucune trace que mon corps a lutté contre ça. Je lui ai ensuite rappelé mon traitement des USA qui se base sur phagothérapie (elle avait oubliée), et m’a dit que c’était vraiment très bien que j’ai pu avoir l’opportunité de bénéficier de ça! Et que si j’en avais les moyens, le continuer ne serait que bénéfique. Car pour rappel le traitement des États-Unis est justement fait pour tout éradiquer, d’où le fait que je n’ai même plus les anticorps. Après malheureusement il existe énormément d’espèces de Bartonella. Moi on m’a seulement contrôlé la plus basique : Bartonella henselae. Hors aux États-Unis ont m’en a trouvé 4 espèces. Est-ce que tout a bien été éradiqué ? Je ne sais pas car pour être sûre il faudrait faire des tests plus poussé, qui ne sont pas pris en charge et très coûteux.. En tout cas on part du principe que je n’ai plus la Bartonella et c’est déjà très prometteur comme avancé !! Ce qu’il faudrait c’est éliminé les infections une part une. Mais même ainsi le corps garde énormément de dégâts, de toxine. Le docteur me disait que face à cela il faut faire du sauna, de l’oxygénothérapie hyperbare.. bref tout ce que je faisais aux États-Unis car c’est extrêmement bénéfique pour rebooster son corps! Heureusement que je peux au moins faire l’oxygénothérapie hyperbare gratuitement en France grâce à de superbes personnes!! Après encore une fois tout cela est trop coûteux… Malheureusement pour s’en sortir avec ce genre de maladie, il faut les moyens et surtout s’y connaître bien. Nous avons reparlé de mes réactions aux antibiotiques, évidemment elle a tout de suite compris mon problème et m’a dit que tous mes symptômes s’amplifient car je suis infesté de bactéries jusqu’au bout de ma tête et que le moindre antibiotique est une aggression pour eux.. Le docteur m’a donc re prescrit un antibiotique juste comme test au cas où je tolère cette fois-ci. Car ça ne pourrait être que bénéfique d’éliminer ce qui est néfaste. J’ai vraiment peur de le prendre car les effets sont intolérables.. Bon, le Dr m’a dit de ne surtout pas tout commencé en même temps (fer, zinc, nouvelle nutrition etc..) comme ça si j’ai des effets secondaires, on saurait de quoi ça vient. D’ailleurs on a refais le point sur tous mes symptômes, elle évoquait certains symptômes que j’ai au quotidien dont je ne savais même pas que c’était lyme ! Ça faisait vraiment du bien de se sentir comprise!
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psalm40speakstome · 3 months
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Having OCD is like hearing the word fire and getting second degree burns.
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oliveasaltylife · 4 months
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Well, it’s finally happening. My parents are withdrawing a portion of my monthly financial support. My husband has been out of work since early October and he finally found a job, but isn’t able to start until January.
We desperately need help to be able to make rent, pay utilities, and get food on the table on top of other monthly bills that can not go unpaid. I have spent the past 2 years begging my parents for the help they explicitly promised me when they found out my FIL gave me COVID in January 2022. I never recovered and still have a whole host of other complex health conditions that was significantly exacerbated. I still don’t have a definitive answer whether or not Long COVID is part of it because it reactivated a latent Bartonella infection that I got who knows how long ago. Not to mention the connective tissue disorder, dysautonomia, MCAS, chiari, and tethered cord I was already dealing with pre-infection, just undiagnosed and not taken seriously. My parents offered to help me financially because I had to stop working. I went back to work after my infection cleared, even though I know I wasn’t fully recovered, and relapsed very hard in May of 2022. That was when the full financial assistance from my parents really began, and they continued to try to convince me they would never turn down helping me.
For the next 6 months my mother berated me and made it known that she resents me because she wasn’t able to get “her pool” installed in the summer of 2022 because she had to help me, her eldest daughter. At one point she made me choose between my health and wellbeing or my sister’s (she is also disabled, but lives at home, and receives SSDI, which I do not qualify for). She ate her words that time. But they’ve been trying to get out of helping me ever since they offered. And now, my parents have taken it upon themselves to lower my financial assistance after my husband lost his job, and without even consulting me. They texted my husband, never made contact with me, and when I called them out on it made excuses that I don’t talk to them often enough. (Huh, imagine that. I don’t really want to contact my abusive parents, but it sure does highlight some of the abuse that’s gone on my entire life). I am not in a position to be able to turn down what they are giving me, though I can not wait until the day I can officially become no contact.
I need help. I’m exhausted from trying to fight for assistance I was promised by my own parents in addition to the extreme exhaustion that comes with living with complex chronic illness. I don’t know what to do at this point. I’m going to leave my Venmo link in hopes that maybe some of you are in a position that allows you to give assistance. If you are not able to, please share this. I don’t have a platform on any of my socials and really do not feel comfortable sharing it on Facebook where I have family members who also choose to ignore pleas for help.
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diariesofabuggygirl · 6 months
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Hello Again. Long time no see.
You haven't heard from me for a while. I was doing really well. Between the strain on my parents and I's relationship, and the improvement in my health I moved out.
It was great. I was so hopeful, and mostly able to care for myself.
The brand new apartment building hadn't been built correctly. I got hit by mold bad. I've been out of it for almost six months. I'm really sick again. It's better than it was, but, it's a nightmare.
I had finally started getting a lot of the positive effects from my neuro surgeries. That, figuring out my trauma, and medical cannabis changed my life.
Now I'm mostly bedridden again. My cannabis isn't as effective. My tolerance is crazy. And tolerance breaks aren't well tolerated, and don't help much. I am so tired of being uncomfortable, in pain, fatigued, and anxious.
I'm so devastated. Assisted suicide is feeling like an option again, though I plan on giving myself time first. I hate it. I hate I need this outlet again. I hate I'm back here in this place.
I cant stop thinking about what my life will look like when my parents are gone. Our relationship is much improved, thank god. But theyr'e at the point in life that kids are supposed to start taking care of them. And here I am still unable to care for myself, and they are having to burn themselves out for me.
They've worked on nothing but me and my health for 16 years this month.
I have one good friend. My relationship with my sibling is much improved. But I am so lonely. I want a partner so badly. And I don't even feel well enough to spend much time with the people i do have. When my parents pass, which I hope is far from now, my life will be so empty.
I am terrified. I don't know what else to say.
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seaseachronix · 4 months
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Guys, I’ve been thinking I have Bartonellosis, I have all the symptoms, fever, anxiety, depression, rage, and also blurry vision and vision problems, anyone else think so?
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lymefordummies · 2 years
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drugcarts · 10 months
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Trench fever is also called as "five-day fever". Bartonella quintana bacteria is primarily carried by a vector called the body louse.
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femmeboyhooters · 1 year
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Anyone with chronic lyme disease have the rash come in when treating?
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ephemerabanter · 3 months
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Fellow Lyme warrior "Bartonella Babe" checked out of this mortal plane a few days ago.
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Apparently her quality of life had decreased to a point where she could no longer bear it.
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Suicide is the leading cause of death for people with Lyme disease.
Lyme patients deserve better.
Rest in Peace, Jake
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housemddiseases1 · 2 years
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House md. Hastalıklar için👉@housemd_disease . . . #housemd #drhouse #everybodylies #doctorhouse #tusmer #tusdata #tusem #tusworld #tustime #tuspecial #30ağustoszaferbayramı #mustafakemalatatürk #atam #büyüktaarruz #bağımsızlık #kurtuluşsavaşı #minnetle #stajtorbayaellerhavaya #bartonella #keditırnağıhastalığı #bartonellahenselae (Medical Faculty Auditorium, Karapitiya) https://www.instagram.com/p/Ch4M2RTDRKl/?igshid=NGJjMDIxMWI=
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yaminahsaini · 3 months
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Aujourd’hui j’ai eu rdv avec le docteur qui m’avait diagnostiquée de lyme/Bartonella etc… Ce docteur est vraiment super, elle est d’une gentillesse/empathie comme on en trouve de plus en plus rarement dans le domaine médicale… très pro, elle veut vraiment aider. Elle m’a demandé ce qu’en pensait mes médecins par rapport à ma Bartonellose, et lorsque je lui ai dis qu’ils ne prenaient pas en compte ça/qu’ils n’en avaient rien à faire, elle se sentait vraiment désolé que ce soit ainsi.. mais bon elle connaît bien à quel point ce genre de choses est tabou/négliger/méconnu en France. Je lui ai montré les résultats des analyses que j’avais faites aux États-Unis. Elle m’a dit que ce sont des examens extrêmement sophistiqué dont elle même n’y comprend rien et ne saurait pas m’aider là-dessus. Au moins elle est honnête et sincère! Souvent les médecins préfèrent nous négliger que admettre que ça dépasse leurs compétences… Le docteur m’a aussi fait part du fait que c’est vraiment dommage d’avoir commencé tout ça aux États-Unis pour finalement ne pas pouvoir continuer la thérapie. Pour rappel seul les moyens financiers ne me permettent pas d’y retourner, mais je compte bien continuer le suivi là-bas, tout dépend de cette cagnotte mais ça n’avance malheureusement pas assez…➡️ https://www.leetchi.com/fr/c/pour-continuer-mes-soins-medicaux-aux-etats-unis-wobp0j2a , d’ailleurs elle est toujours ouverte et tous les dons me sont d’une grande aide. Merci à ceux qui m’ont déjà beaucoup aidé🙏 Du coup suite à ce rdv, le docteur m’a re prescrit une prise de sang à faire afin de voir si il y’a une différence suite à la thérapie des États-Unis. Nous allons seulement contrôler ce qui était beaucoup trop élevé la dernière fois (et surtout bartonella). Comme d’habitude je vous tiens informé de tout.
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(Lundi 8 janvier 2024)
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psalm40speakstome · 8 months
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youtube
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hickoryhorneddevils · 4 months
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been noticing my stretch marks have been white for a while which is very reassuring :)
[THIS POST IS ABOUT BEING BEING DISEASED WITH A BLOOD INFECTION NOT ABOUT WEIGHT]
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squishmallow36 · 2 years
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okay my microbiology class is having me look up pathogenic bacteria and so many have ae somewhere in the scientific name. cholera should not be as gender as it is someone send help
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metal-cn · 8 months
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猫ひっかき病、Bartonella henselae!リンパ腫れる、だけやなく、、、それは誰でも知ってるやろな。
詳しいことは、必ず高度な専門家へ。抗体的治療せんと、年単位で、長引く、、、これもみな、知っておりはりますよね。また、肝炎なんらもね。
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