Rheumatological presentation of Bartonella koehlerae and Bartonella henselae bacteremias: A case report

Mozayeni, Bobak, Robert, MDa; Maggi, Ricardo, Guillermo, PhDb; Bradley, Julie, Meredith, BSb; Breitschwerdt, Edward, Bealmear, DVMb,*

Medicine: April 2018 – Volume 97 – Issue 17 – p e0465
doi: 10.1097/MD.0000000000010465
Research Article: Clinical Case Report


Introduction: Systemic Bartonella spp. infections are being increasingly reported in association with complex medical presentations. Individuals with frequent arthropod exposures or animal contact appear to be at risk for acquiring long standing infections with Bartonella spp.

Case report: This case report describes infections with Bartonella koehlerae and Bartonella henselae in a female veterinarian whose symptoms were predominantly rheumatologic in nature. Infection was confirmed by serology, polymerase chain reaction (PCR), enrichment blood culture, and DNA sequencing of amplified B koehlerae and B henselae DNA. Long-term medical management with antibiotics was required to achieve elimination of these infections and was accompanied by resolution of the patient’s symptoms. Interestingly, the patient experienced substantial improvement in the acquired joint hypermobility mimicking Ehlers–Danlos Syndrome (EDS) type III.

Conclusion: To facilitate early and directed medical interventions, systemic bartonellosis should potentially be considered as a differential diagnosis in patients with incalcitrant rheumatological symptoms and frequent arthropod exposures or extensive animal contact.



Bartonella isn’t even on most GP’s radars regarding tick borne illness, and in fact many deny ticks can even transmit it, yet here we see that those with arthropod exposure and/or animal contact need to consider it.  Isn’t that just about everyone under the sun?

You need to know this for yourself, friends and family.  Educate the doctors!

This poor female veterinarian was put on clindamycin & rifampin but had to discontinue after becoming pregnant.  She had a thousand symptoms:  axillary lymphadenopathy from cat scratch disease (CSD) at 12 years of age, a tibial sesamoid bone fracture, plantar fasciitis, generalized muscle/joint pain, muscle weakness, headaches, tingling, and fatigue, cervical lymph node enlargement, extremity edema, ligamentous laxity, tenosynovitis, shoulder and elbow subluxations, elbow joint crepitus, progressively worsening joint hypermobility (Beighton score 7/9), multiple joint subluxations daily, and breast cysts, meeting criteria for benign classification.

Please note the joint popping with each articulation and continual joint subluxation issue.  

Chiropractors need to be told about this.  Please educate!  Send them this article.

I too had this bizarre popping of the joints with a lot of instability in the knees.  Treatment completely ameliorated this issue so treatment is primo important.

For more on Bartonella:  (Tons more links on Bart after this article)






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