https://medicaldetective.substack.com/p/bartonella-the-second-great-imitator
Bartonella is the third “B” of the triad found in the vast majority of my chronically ill patients who suffer from chronic Lyme disease/PTLDS, along with Borrelia and Babesia.A gram-negative intracellular bacteria, it’s controversial and misunderstood and has been throwing a monkey wrench into my treatments for decades. I barely remember learning about it in medical school, except when they were teaching me about cat scratch fever in children that would cause small, localized rashes (papules) at the site of the scratch with swollen lymph nodes and fevers. It would be treated with a short course of antibiotics like azithromycin. These images show classical cat scratch disease before and after treatment when the lesions are starting to crust up. (See link for article)
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https://medicaldetective.substack.com/p/bartonella-establishing-the-diagnosis
Bartonella: Establishing the Diagnosis, and the Role of Multiple Bartonella Species and MSIDS Factors in Chronic Illness – Part 2 of 5
Feb 12, 2025
As you learned last week in Bartonella Part 1, this is a very tricky bacteria, with symptoms overlapping many of those associated with chronic Lyme disease and other co-infections. Since there are so many species of Bartonella, the first step is to determine if Bartonella is actually in your body. As a Medical Detective, I know that there are certain clues to follow, but what exactly are they?
Let’s start at the beginning. You’ve been diagnosed with chronic Lyme disease–you had a prior EM rash and/or filled out the questionnaire and scored above 63, implying a high likelihood of exposure. See the prior Medical Detective Substacks on using this HMQ questionnaire:
https://cangetbetter.com/wp-content/uploads/2021/02/MSIDS-QUESTIONNAIRE-FINALR.pdf
(See link for article)
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https://medicaldetective.substack.com/p/effective-treatments-for-bartonella
Bartonella is an intracellular biofilm/persister bacteria, like Borrelia burgdorferi, the bacterial agent of Lyme disease. For years, many doctors were using single drug therapies for Cat Scratch Disease (CSD), even in the chronic persistent phases of the infection (some may still). This was before we understood the complexity of how this bacteria persists.
Years ago, however, I did recognize that at least 2 intracellular antibiotics were more effective than one for difficult-to-treat intracellular infections. So for many years I treated Bartonella with doxycycline/rifampin or Zithromax/rifampin. Although they helped to knock down symptoms, Bartonella would invariably return after antibiotics were stopped. Persisters persist! (See link for article)
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https://medicaldetective.substack.com/p/treating-bartonella-double-dose-dapsone
In Bartonella Parts 1, 2, and 3, you learned the basics of Bartonella testing, symptoms, and treatment options, with a detailed discussion of laboratory work needed before starting the protocol, and how/why the medication and support supplements are being used to increase the tolerability and safety of DDDCT and HDDCT. Please review this information with your doctor before proceeding with the antibiotic protocol listed below. (See link for article)
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https://medicaldetective.substack.com/p/treating-bartonella-2-week-pulses
Treating Bartonella: 2-Week Pulses of Antibiotics for Chronic Bartonellosis – Part 5 of 5
Bravo! You’ve made it to Part 5, the final Medical Detective Substack on diagnosing and treating chronic Bartonella infections. As you read in the previous 4 Substacks, Bartonella is often found in my chronic Lyme patients, at least 80% of the time, right behind active Babesia infections–watch for unexplained fevers, day/night sweats, chills, flushing, “air hunger,” and an unexplained cough if you have ongoing Babesia. (See link for article)
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For more:
Madison Area Lyme Support Group 