Neurological presentations of Bartonella henselae infection.

Canneti B, et al. Neurol Sci. 2018.


OBJECTIVE: Neurological symptoms in patients with cat-scratch disease (CSD) have been rarely reported. The aim of this study is to analyze the frequency of neurological CSD (NCSD) and describe the disease clinical presentation, management and outcome.

MATERIAL AND METHODS: We retrospectively selected patients with a CSD syndrome and Bartonella IgG titers > 1:256. Data regarding epidemiological, clinical, management, and follow-up features were analyzed and discussed. A comparison between NCSD and non-neurological CSD (NNCSD) was established.

RESULTS: Thirty-nine CSD patients were selected. NCSD frequency was 10.25%. No children were found affected in the NCSD group. A 65.7% of NNCSD and the entirety of the NCSD group had a history of cat exposure. Immunosuppression was only present in the NNCSD group (8.6%).

NCSD presentations were as follows:

  1. neuroretinitis (50%)
  2. isolated aseptic meningitis (25%)
  3. isolated optic neuritis (25%)

A greater proportion of patients in the NCSD group had fever and raised levels of acute phase reactants and white blood cells.

  • 85.7% of NNCSD had a complete recovery
  • only 50% of the NCSD patients experienced a full recovery

CONCLUSION: NCSD may be a distinctive group compared to NNCSD due to its later age of presentation, the more intense systemic response, and the poorer outcome.



This study shows what is being experienced in Lyme-land.  Bartonella is a big player and complicates things exponentially.  This study shows that Bartonella alone is a formidable pathogen.  It doesn’t even consider Lyme Disease as a co-factor but rather studies Bartonella alone.  Together, they are a “one, two punch,” and you are down for the count.  Throw in Babesia, a few viruses, and nematodes (all of which can be transmitted by the same bite of a singular tick) and it becomes pretty evident why patients are not improving – especially on the CDC’s mono therapy of doxycycline.

Please notice that only 50% of those with neurological “cat scratch disease,” (NCSD) experienced full recovery.  Imagine the percentage if Lyme was taken into account….

Also, please note the eye involvement (neuroretinitis & optic neuritis).  There are 1,000 other presentations of Bartonella as well.  Almost every patient I work with has NCSD.  Many with severe psychiatric presentations.

More on Bartonella:

I could seriously go on to infinity but will stop here.