Archive for the ‘Bartonella’ Category

Bartonella: Endocarditis, Opportunistic Infection in Cancer Patients, and Eye Inflammation  Bartonella Species, an Emerging Cause of Blood-Culture-Negative Endocarditis.

Okaro U1, Addisu A2, Casanas B2, Anderson B3. Clin Microbiol Rev. 2017.

Since the reclassification of the genus Bartonella in 1993, the number of species has grown from 1 to 45 currently designated members. Likewise, the association of different Bartonella species with human disease continues to grow, as does the range of clinical presentations associated with these bacteria. Among these, blood-culture-negative endocarditis stands out as a common, often undiagnosed, clinical presentation of infection with several different Bartonella species. The limitations of laboratory tests resulting in this underdiagnosis of Bartonella endocarditis are discussed. The varied clinical picture of Bartonella infection and a review of clinical aspects of endocarditis caused by Bartonella are presented. We also summarize the current knowledge of the molecular basis of Bartonella pathogenesis, focusing on surface adhesins in the two Bartonella species that most commonly cause endocarditis, B. henselae and B. quintana. We discuss evidence that surface adhesins are important factors for autoaggregation and biofilm formation by Bartonella species. Finally, we propose that biofilm formation is a critical step in the formation of vegetative masses during Bartonella-mediated endocarditis and represents a potential reservoir for persistence by these bacteria.  Seroprevalence of Bartonella species, Coxiella burnetii and Toxoplasma gondii among patients with hematological malignancies: A pilot study in Romania.

Messinger CJ1, Gurzau ES2,3, Breitschwerdt EB4,5, Tomuleasa CI6,7, Trufan SJ8, Flonta MM9, Maggi RG4,5, Berindan-Neagoe I6,10,11, Rabinowitz PM8. Zoonoses Public Health. 2017.

Patients receiving immunosuppressive cancer treatments in settings where there is a high degree of human-animal interaction may be at increased risk for opportunistic zoonotic infections or reactivation of latent infections. We sought to determine the seroprevalence of selected zoonotic pathogens among patients diagnosed with haematologic malignancies and undergoing chemotherapeutic treatments in Romania, where much of the general population lives and/or works in contact with livestock. A convenience sample of 51 patients with haematologic cancer undergoing chemotherapy at a referral clinic in Cluj-Napoca, Romania, was surveyed regarding animal exposures. Blood samples were obtained and tested for evidence of infection with Bartonella species, Coxiella burnetii and Toxoplasma gondii, which are important opportunistic zoonotic agents in immunocompromised individuals. 58.8% of participants reported living or working on a farm, and living or working on a farm was associated with contact with livestock and other animals. 37.5% of participants were IgG seroreactive against one or more of five Bartonella antigens, and seroreactivity was statistically associated with living on farms. Farm dwellers were 3.6 times more likely to test IgG seroreactive to Bartonella antibodies than non-farm dwellers. 47.1% of the participants tested T. gondii IgG positive and 13.7% tested C. burnetii IgG positive, indicating past or latent infection. C. burnetii IgM antibodies were detected in four participants (7.8%), indicating possible recent infection. These results indicate that a large proportion of patients with haematologic cancer in Romania may be at risk for zoonotic infections or for reactivation of latent zoonotic infections, particularly with respect to Bartonella species. Special attention should be paid to cancer patients’ exposure to livestock and companion animals in areas where much of the population lives in rural settings.  Seroprevalence of Bartonella Species in Patients with Ocular Inflammation.

Brydak-Godowska J1, Kopacz D1, Borkowski PK2, Fiecek B3, Hevelke A4, Rabczenko D5, Tylewska-Wierzbanowska S3, Kęcik D1, Chmielewski T3. Adv Exp Med Biol. 2017.

Bartonella species, vector-borne etiologic agents of many systemic or self-limited infections, are responsible for a widening spectrum of diseases in humans, including inflammatory conditions of the eye. The aim of this study was to determine whether there is any relationship between uveitis and the evidence of Bartonella spp. infection in the serum, ocular fluid, and cataract mass in patients with intraocular inflammation. Polymerase chain reaction (PCR)-based tests and DNA sequencing were performed on surgery-extracted specimens of intraocular fluid and lens mass of 33 patients. Sera from 51 patients and 101 control subjects were tested for the presence of specific antibodies against Bartonella spp. Neither IgM-class antibodies against Bartonella spp. nor Bartonella spp. DNA were detected. A specific IgG-class antibody was found in 33.3% of the patients with uveitis. The rate of positive Bartonella serology was higher among the uveitis patients than that in control subjects. This high rate may in part result from unrecognized indirect mechanisms rather than the immediate presence and multiplication of Bartonella spp. in the eyeball. Nonetheless we believe that screening for Bartonella spp. should become part of the diagnostic workup in uveitis.

Another ocular study:

Bartonella Henselae in Children with Congenital Heart Disease

The Pediatric Infectious Disease Journal. 36(5):516-520, MAY 2017

Christopher P Ouellette; Sarita Joshi; Karen Texter; Preeti Jaggi


Two children with congenital heart disease status post surgical correction presented with prolonged constitutional symptoms, hepatosplenomegaly (simultaneous enlargement of both the liver (hepatomegaly) and the spleen (splenomegaly) and pancytopenia (decrease in red blood cells, white blood cells and platelets).

Concern for malignancy prompted bone marrow biopsies that were without evidence thereof. In case 1, echocardiography identified a multilobulated vegetation on the conduit valve. In case 2, transthoracic, transesophageal and intracardiac echocardiography were performed and were without evidence of cardiac vegetations; however, pulmonic emboli raised concern for infective endocarditis. Both patients underwent surgical resection of the infected material and had histopathologic evidence of infective endocarditis. Further diagnostics identified elevated cytoplasmic antineutrophil cytoplasmic antibodies and antiproteinase 3 antibodies in addition to acute kidney injury with crescentic glomerulonephritis on renal biopsy. Serologic evidence of infection with Bartonella henselae was observed in both patients. These 2 cases highlight the potential multiorgan involvement that may confound the diagnosis of culture-negative infective endocarditis caused by B. henselae.

Co-infection of Ticks: The Rule Rather Than the Exception

Sara Moutailler, Claire Valiente Moro, Elise Vaumourin, Lorraine Michelet, Florence Hélène Tran, Elodie Devillers, Jean-François Cosson, Patrick Gasqui, Van Tran Van, Patrick Mavingui, Gwenaël Vourc’h, Muriel Vayssier-Taussat
Published: March 17, 2016



Ticks are the most common arthropod vectors of both human and animal diseases in Europe, and the Ixodes ricinus tick species is able to transmit a large number of bacteria, viruses and parasites. Ticks may also be co-infected with several pathogens, with a subsequent high likelihood of co-transmission to humans or animals. However few data exist regarding co-infection prevalences, and these studies only focus on certain well-known pathogens. In addition to pathogens, ticks also carry symbionts that may play important roles in tick biology, and could interfere with pathogen maintenance and transmission. In this study we evaluated the prevalence of 38 pathogens and four symbionts and their co-infection levels as well as possible interactions between pathogens, or between pathogens and symbionts.

Methodology/principal findings

A total of 267 Ixodes ricinus female specimens were collected in the French Ardennes and analyzed by high-throughput real-time PCR for the presence of 37 pathogens (bacteria and parasites), by rRT-PCR to detect the presence of Tick-Borne encephalitis virus (TBEV) and by nested PCR to detect four symbionts. Possible multipartite interactions between pathogens, or between pathogens and symbionts were statistically evaluated. Among the infected ticks, 45% were co-infected, and carried up to five different pathogens. When adding symbiont prevalences, all ticks were infected by at least one microorganism, and up to eight microorganisms were identified in the same tick. When considering possible interactions between pathogens, the results suggested a strong association between Borrelia garinii and B. afzelii, whereas there were no significant interactions between symbionts and pathogens.


Our study reveals high pathogen co-infection rates in ticks, raising questions about possible co-transmission of these agents to humans or animals, and their consequences to human and animal health. We also demonstrated high prevalence rates of symbionts co-existing with pathogens, opening new avenues of enquiry regarding their effects on pathogen transmission and vector competence.

Author Summary

Ticks transmit more pathogens than any other arthropod, and one single species can transmit a large variety of bacteria and parasites. Because co-infection might be much more common than previously thought, we evaluated the prevalence of 38 known or neglected tick-borne pathogens in Ixodes ricinus ticks. Our results demonstrated that co-infection occurred in almost half of the infected ticks, and that ticks could be infected with up to five pathogens. Moreover, as it is well established that symbionts can affect pathogen transmission in arthropods, we also evaluated the prevalence of four symbiont species and demonstrated that all ticks were infected by at least one microorganism. This work highlights the co-infection phenomenon in ticks, which may have important implications for human and animal health, emphasizing the need for new diagnostic tests better adapted to tick-borne diseases. Finally, the high co-occurrence of symbionts and pathogens in ticks, reveals the necessity to also account for these interactions in the development of new alternative strategies to control ticks and tick-borne disease.

To which we all said AMEN!

A few notes on the study:  To see a chart showing exactly what coinfections and symbionts they looked at, go to the link for the study.  They looked at 6 strains of borrelia (Lyme), Anaplasma, Ricketssia helvetica, Bartonella, Babesia, and Neoehrlichia mikurensis (Order: Rickettsiales, Family: Anaplasmataceae).  The symbiots looked at were:  Wolbachia, Spiroplasma, Acinetobacter, and Midichloria mitochondri.

While I am unfamiliar with most of the symbionts, Wolbachia concerns me as scientists are actively inserting Wolbachia into mosquitoes and releasing them into the wild in efforts of eradicating Dengue Fever, Chikungunya, yellow fever, and possibly even Malaria.  While scientists claim Wolbachia, a gram-negative bacterium in the family of Rickettsiales, can not infect humans, they can and do infect worms which cause human disease.  Since nematodes have been found in ticks and many Lyme/MSIDS patients have to treat for worms, the question begs to be asked, “Does Wolbachia play a role in Lyme/MSIDS?”  This is a question I plan on writing about, but the answer could very well be, “Yes.”  I certainly pray that more research on Wolbachia in relation to Lyme/MSIDS is done as this could definitely be a fly in the proverbial ointment.

Lastly, I believe recorded coinfection numbers to be abysmally low.  My own LLMD doesn’t even test for them, he feels the tests are that poor.  Also, probably the numbers reflect the most severe cases – leaving many out.  As you are aware, coinfections are notorious for presenting differently than the textbook presentations that most doctors are familiar with. Dr. Horowitz writes and speaks about this often.

Published on Nov 3, 2014
At the “Symposium on Tick-borne Diseases” held May 17, 2014

37:30 You will only find a positive test for Babesia if the level of parasitima in the blood is greater than 5%.  38:05 Medical textbooks also state you should have hemolytic anemia, thrombocytopenia, and renal failure if you have Babesia.  Dr. Horowitz states he has not had one Lyme/MSIDS patient present this way.  

How many doctors are going to think outside their medical textbooks?

Bartonella – A Growing Health Concern  Posted Apr. 6th, 2017 by Jamie Rothenburger

Soldiers in WWI and even WWII were sidelined by Trench Fever, a strain of Bartonella transmitted from lice that gave them headaches, low back and shin pain, fever, and dizziness. Today, it is a disease of the homeless as well as many Lyme/MSIDS patients.

Bart’s insidiousness stems from the fact it doesn’t stimulate the immune system to mount a defense as it takes over red blood cells. For more:

While many are familiar with Cat Scratch Fever, a common strain of Bart, there are many others, and every species which causes disease in dogs also infects humans.

As the author, Jamie Rothenburger, veterinarian and PhD student at Ontario Veterinary College states, the best prevention of disease is by controlling fleas and ticks as both carry the pathogen, along with transmission from bites and scratches from cats and now deer keds (found in link above on vectors).

Bartonella Vectors

  Published on Jul 14, 2016
Dr. Tom Mather and Dr. Ed Breitschwerdt on the growing risks of tick and flea exposure from “Healthy Body, Healthy Minds” with special thanks to ITV productions.

Bartonella is a formidable coinfection for many Lyme/MSIDS patients.  Symptoms are largely associated with where blood flow is compromised:

Skin rashes (stretch-mark-like), cysts, heartburn, abdominal pain, chest pain, gastritis, duodentis, mesenteric adenitis, psychological issues (anxiety, anger, suicidal thoughts, depression, irritability), pain in the soles of the feet, skin tags and red papules, endocarditis, acute encephalopathy, seizures, visual and auditory hallucinations, ocular floaters, fatigue, partial paralysis, laryngitis, severe confusion, difficulty swallowing, muscle weakness, and vasculitis that occurs anywhere in the body which can destroy blood vessels.  For a longer list of symptoms see:

Since it exists in very low amounts in human blood, blood tests are unreliable. It also has a long division time between 22-24 hours and requires a special growth environment. There is a Triple Draw through Galaxy which collects blood over 8 days to maximize the test, stating a 90% reduction in false negatives.   Vectors include fleas and flea feces, biting flies such as sand flies and horn flies, the human body louse, mosquitoes, mites, and ticks; through bites and scratches of reservoir hosts; and potentially from needles and syringes in the drug addicted. Needle stick transmission to veterinarians has been reported. There is documentation that cats have received it through blood transfusion.

Bartonella has recently been found in winged adult deer keds in Finland:

Moose as reservoirs, deer keds as vectors in Norway:

Bartonella infection in southern Finnish moose was 90.6% (inside the deer ked zone), while northern Finnish moose was 55.9% (outside the deer ked zone). At least two species of bartonellae were identified.

Just what are deer keds?  In the fly family (6 legs), they will chuck their wings as soon as they land on a host to suck blood more easily.

For more on Bartonella:

Gardasil, Female Reproduction, & Lyme/MSIDS  Published April 12, 2017

Girl’s Ovaries Destroyed by Gardasil: Merck Did Not Research Effects of Vaccine on Female Reproduction

by Arjun Walia

Please see link above for entire article.

Numerous studies have shown that studies to approve vaccines do not specifically look for serious adverse reactions.  

This article cites numerous young women who had adverse reactions after receiving the HPV vaccine which includes premature ovarian failure (POF) and premature ovarian insufficiency.

Even the College of Pediatrics put out a statement:

It has recently come to the attention of the College that one of the recommended vaccines could possibly be associated with the very rare but serious condition of premature ovarian failure (POF), also known as premature menopause. There have been two case report series (3 cases each) published since 2013 in which post-menarcheal adolescent girls developed laboratory documented POF within weeks to several years of receiving Gardasil, a four-strain human papillomavirus vaccine (HPV4).

According to Walia, original rat safety studies and human vaccine trials did not assess long term ovarian function, and since licensure of Gardisil in 2006 there have been around 213 VAERS adverse reaction reports including premature menopause and amenorrhea – 88% of which are associated directly with Gardasil.

Malia states that many doctors are unaware of the possible connection between Gardasil and POF and may not even think to report to VAERS these POF cases or even girls missing menses for a protracted time.

The reason this is important for Lyme/MSIDS patients is the connection between Gardasil and Bartonella:

Hidden Invaders: Infections Can Trigger Immune Attacks on Kids’ Brains Provoking Devastating Psychiatric Disorders  By Pamela Weintraub Wednesday, March 29, 2017

Hidden Invaders:  Infections can trigger immune attacks on kids’ brains, provoking devastating psychiatric disorders.

Please read Weintraub’s detailed article in link above about seven year old Paul who changed over night, due to pediatric acute-onset neuropsychiatric syndrome (PANS).  

“PANS is thought to be an inflammatory condition that results when an infection or some other invasive trigger spurs the body to turn on itself and attack structures in the brain. For years, scientists had focused on a single infection — group A streptococcal disease — that produced antibodies that attacked the part of the forebrain involved in forming habits, resulting in OCD. Today, the paradigm has widened into a much bigger idea that expands our understanding of psychiatric disease: A whole host of infections and other unknown triggers lead to the production of antibodies and immune cells that can cross into the brain. Depending on where these immune responses land and which brain structures they block, erode or destroy, a range of psychiatric ills can result. In one person, it could be OCD; in the next, it could be hyperactivity and inattention, anxiety, restricted eating, even hallucinations or autistic behavior.”

A prominent Wisconsin Lyme literate doctor states that 80% of his PANS children are also infected with Lyme/MSIDS.  They respond and improve with antibiotics, diet change, probiotics, and other supplements to improve immune function. According to Weintraub, researchers are trying to find the right treatment that stops inflammation and immune dysfunction due to rogue antibodies that attack the brain.

Weintraub also reports that strep infections can cause neuropsychiatric symptoms.  One psychiatrist found that some patients right after a strep infection could develop OCD and eating disorders.  She also found that children with OCD from PANDAS had toxic behavior reactions to typical medications that helped those with standard OCD showing the two groups were not equal.  In studying 43 children with acute onset OCD, the infectious triggers were strep and mycoplasma.  She treated them with Azithromycin and the patients improved.

Untreated PANS children can be disabled by their psychiatric symptoms and have, “OCD with severe intrusive thoughts such as suicidal ideation, psychosis, deep anxieties and fears, panic, rage, and are at risk of committing violent acts, ” as well as cognitive problems such as:  “handwriting deterioration, slow processing speed and regressions so frightening that a once-normal 10-year-old might have the skills and behavior of a developmentally slow 3-year-old.”

A pediatric rheumatologist managed to find clusters of children from the same school or neighborhood who had all come down with the condition in the same month as well as other infections besides strep were involved, such as bacterial mycoplasma, influenza, sinusitis, pneumonia and others.  Incredible video by Dr. Marke with written highlights and discussion on PANDAS/PANS.