Archive for the ‘Ticks’ Category

Lyme Disease Changed This Woman’s Life

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Lyme Disease Changed This Woman’s Life

April 24, 2025

CTV News

A Huron County woman is sharing her experience with Lyme disease.

A few points:

If you need a Lyme literate doctor the best place to look is your state’s Lyme support groups.  These folks are the boots on the ground that know the local doctors and which ones are experienced.

For more:

Listen to Willy Burgdorfer, the “discoverer” of Lyme disease:

“The controversy in Lyme disease research is a shameful affair. I say that because the whole thing is politically tainted. Money goes to people that have for the past 30 years produced the same thing. Nothing.  Serology or serology plus has to be started from scratch with people that don’t know beforehand the results of their research.

Sadly, current research is taking the same old tack that people are simply struggling with inflammation (PTLDS) – not an active infection.  While this is always true, it is often only a partial truth, with active infection being the driver to the inflammation.  In other words, treat the infection and symptoms get better or go away entirely.  If only inflammation is treated, symptoms will continue until the infection(s) is/are dealt with.  And this brings up another point entirely dismissed by mainstream research and medicine: this is commonly a polymicrobial issue – meaning more than one infectious organism is involved requiring yet more savvy, complex treatments.  The patient in the video doesn’t mention this at all making me wonder if she even knows about coinfections; however, I’ve done enough media interviews to understand that everything has to be condensed down into a two minute sound-bite which is impossible with a complex topic like Lyme/MSIDS.

Category:

Activism, Lyme, Testing, Ticks, Treatment

Piperacillin Kills Lyme Bacteria in Mice, Leaves Gut Microbiome Alone

https://www.lymedisease.org/piperacillan-kills-lyme/

Piperacillin kills Lyme bacteria in mice, leaves gut microbiome alone

From Northwestern University:

Lyme disease, a disease transmitted when deer ticks feed on infected animals like deer and rodents, and then bite humans, impacts nearly half a million individuals in the U.S. annually.

Even in acute cases, Lyme can be devastating; but early treatment with antibiotics can prevent chronic symptoms like heart and neurological problems and arthritis from developing.

Scientists from Northwestern University have identified that piperacillin, an antibiotic in the same class as penicillin, effectively cured mice of Lyme disease at 100-times less than the effective dose of doxycycline, the current gold standard treatment.

At such a low dose, piperacillin also had the added benefit of “having virtually no impact on resident gut microbes,” according to the study, in the journal Science Translational Medicine.

Doxycycline and other generic antibiotics, on the other hand, wreak havoc on the microbiome, killing beneficial bacteria in the gut and causing troubling side effects even as it kills the Borrelia bacteria that causes Lyme.

In addition to its negative impact on the gut, doxycycline also fails to help between 10 and 20% of individuals who take it, and it is not approved for use in young children — who are at the highest risk of tick bites, and therefore, of developing Lyme.

More effective, or at least more specific, treatment options are needed as climate change extends tick seasons and Lyme becomes more prevalent.

The need for customized medicine

“Powerful, broad-spectrum antibiotics that kill extracellular bacteria are seen as the most effective medication because physicians want to just kill the bacterium and don’t care how,” said Brandon L. Jutras, who led the research.

“This is certainly a reasonable approach, but I think the future for Lyme disease patients is bright in that we are approaching an era of customized medicine, and we can potentially create a particular drug, or a combination to treat Lyme disease when other fail. The more we understand about the various strains and species of Lyme disease-causing Borrelia, the closer we get to a custom approach.”

Jutras is an associate professor in the microbiology-immunology department of Northwestern University Feinberg School of Medicine, and a member of Northwestern’s Center for Human Immunobiology.

Jutras’s lab was recently named a Phase 3 winner in LymeX Diagnostics, the Steven & Alexandra Cohen Foundation’s $10 million competition to accelerate the development of Lyme disease diagnostics, and in 2021 he won the Bay Area Lyme Foundation Emerging Leader Award.

Piperacillin has already been FDA-approved as a safe treatment for pneumonia.

To reach the conclusion that the penicillin relative would be the most effective and targeted treatment, the team screened nearly 500 medicines in a drug library, using a molecular framework to understand potential interactions between antibiotics and the Borrelia bacteria.

Once the group had a short list of potentials, they performed additional physiological, cellular and molecular tests to identify compounds that did not impact other bacteria.

Prevents bacteria from growing

They found that piperacillin exclusively interfered with the unusual cell wall synthesis pattern common to Lyme bacteria, preventing the bacteria from growing or dividing and ultimately leading to its death.

Historically, piperacillin has been administered as part of a two-drug cocktail to treat severe strep infections because strep can break down beta-lactams (piperacillin’s class of antibiotics) unless accompanied by tazobactam, which is an inhibitor of the enzyme that inactivates piperacillin.

Jutras wondered if using the same two medications, rather than piperacillin alone, would be a more effective bacteria killer.

“Bacteria are clever,” Jutras said. “Strep and some other bacteria combat antibiotics by secreting beta-lactamases that inactivate piperacillin. We found the approach is totally irrelevant in the context of Lyme disease and another way that makes piperacillin more specific. Adding the beta-lactamase inhibitor doesn’t improve the therapy because Lyme Borrelia don’t produce beta-lactamase, but the cocktail does negatively impact the microbiome by becoming more broadly functional against beneficial residents.”

The study was supported by the Bay Area Lyme Foundation and United States Department of Agriculture (VA-160113), the Dennis Dean Research Grant (Virginia Tech), the National Institutes of Allergy and Infectious Disease (R01AI173256, R01AI178711), the Steven & Alexandra Cohen Foundation and the Global Lyme Alliance.

Click here for more about the study.

SOURCE: Northwestern University

_______________

**Comment**

A few points:

  1. Early treatment CAN prevent neurological problems, arthritis, & other chronic symptoms, but fails to do so in a subset of patients.
  2. Doxycycline does has a negative impact upon the gut, but far more than 10-20% go on to suffer long-term symptoms (chronic Lyme), with one researcher estimating the percentage to be more like 60%.  A little factoid: the current research which comes up with 10-20% doesn’t include patients who are diagnosed and treated late, and this is somewhere between 30-40% of patients!
  3. Independent research has proven the climate has nothing to do with tick and disease proliferation.  Further, the entire climate narrative is fraught with fraud and deceit and many experts continue to state there is no climate crisis, atmospheric CO2 emissions can not cause ‘global warming’, and that green energy policies have made the climate worse. Researchers really need to cease and desist with the climate mantra.  
    1. But this ‘tell’ reveals that those doling out federal research grants hold all the cards, and researchers know they must comply with the narrative to get the dollars. These same public health ‘experts’ and politicians also own patents on the very things (drugs, tests, vaccines, etc) they are entrusted to protect the public from as well as set treatment guidelines.
  4. Researcher Kim Lewis out of Northeastern University has also identified compounds that are highly active and selective against Lyme disease in the mouse model. Going all the way back to 2015, he found hygromycin A to be highly effective against Lyme, yet here we are in 2025 with nadda.
  5. Lewis also proved what Dr. Burrascano clinically discovered – that by treating with antibiotics for a period and then stopping for a period (cycling) – if they did this four times, they discovered no bacteria in the petri dishes.
    1. Burrascano and Dr. Alan McDonald also proved patients can test negative but still be actively infected as well as the fact that dosage makes a difference as well.  Mainstream research and medicine are clueless about these nuances and just continue to use a completely antiquated and faulty paradigm.
    2. This is why I hold little hope in any research that is federally funded.  While advocates continue to bemoan lack of federal funding, I say good riddance.  Nothing good ever comes from that quarter anyway.  As long as federal funding is involved, the fraudulent Lyme narrative will taint everything that is done.
    3. Further, the federal government is complicit in tick research that purposely weaponized ticks to deliver deadly bacteria to be incapacitating and dropped them out of airplanes.  Hello!
  6. Don’t believe me?  Listen to Willy Burgdorfer, the “discoverer” of Lyme disease himself:

“The controversy in Lyme disease research is a shameful affair. I say that because the whole thing is politically tainted. Money goes to people that have for the past 30 years produced the same thing. Nothing.  Serology or serology plus has to be started from scratch with people that don’t know beforehand the results of their research.

BOOM.

Sadly, the current research above is taking the same old tack that people are simply struggling with inflammation (PTLDS) – not an active infection.  While this is always true, it is often only a partial truth, with active infection being the driver to the inflammation.  In other words, treat the infection and symptoms get better or go away entirely.  If only inflammation is treated, symptoms will continue until the infection(s) is/are dealt with.  And this brings up another point entirely dismissed by mainstream research and medicine: this is commonly a polymicrobial issue – meaning more than one infectious organism is involved requiring yet more savvy, complex treatments.  

Until these issues are addressed, I don’t want another dime of my money going to the same people that have done nothing for the past 40 years.

For more:

http://  Approx. 3 Min

Could Piperacillin Be the Lyme Breakthrough We Need?

Dr. Danial Cameron

May 6, 2025

Category:

Activism, Lyme, research, Ticks, Treatment

The Three Bs – Borrelia, What, and What? Co-infections & Chronic Illness

https://www.lymedisease.org/the-three-bs-borrelia-what/

The three Bs – Borrelia, What, and What? Co-infections and chronic illness

By Nicole Bell, Galaxy Diagnostics CEO

3/10/25

While many people in the Lyme community are familiar with the three Bs – Borrelia, Bartonella, and Babesia – most people outside the community look confused when I mention these top flea and tick-borne pathogens. I understand their puzzled looks because back in 2017, I was confused too.

Even after my husband, Russ, was diagnosed with these three stealthy invaders, I focused all my research on Borrelia, the bacteria causing Lyme disease.

It ended up taking a tragic journey followed by years of studying the research to gain an appreciation for the complexities of all three pathogens – and that research is still unfolding.

In complex cases, co-infections are the rule, not the exception.

The first thing to understand when considering the three Bs, is that in complex cases, co-infections are common. In a survey of over 3,000 chronic Lyme disease patients published by LymeDisease.org, over 50% had co-infections, and 30% had two or more co-infections. Babesia and Bartonella top the co-infection list, each presenting in about 30% of chronic Lyme cases.

Source: About Lyme Disease Co-infections, LymeDisease.org

The second thing to understand about these pathogens is that calling them “Lyme co-infections” is misleading. All these pathogens – the other Bs and beyond – can be present without a Borrelia  infection (past or present).

The problem is that many doctors don’t have these invaders on their differential – and it’s easy for a pathogen to be considered rare if you never test for it. 

Rare disease? Or inadequate testing and data?

To understand the true prevalence of these pathogens, we need to dig into the details of each pathogen and how we count and test for them. For example, before 2013, Lyme incidence in the U.S. was estimated to be approximately 30,000 cases per year. Then, in 2013, the CDC looked at clinical records, laboratory reports, and public surveys and increased this estimate 10-fold.

In 2021, an analysis of insurance records increased the estimates again, and current data shows that approximately 500,000 Americans are diagnosed and treated annually. And since the standard of care test for Lyme leading to diagnosis and treatment is 40-60% accurate, even this number is likely underestimating the extent of the problem.

So, the question looms – what is the prevalence of the other two Bs? Are they destined for a similar exponential increase as we dig into the data? Emerging research points to yes.

Bartonella – The Hidden Pandemic

Bartonella is a genus of gram-negative bacteria that can infect humans and a wide range of animals. Googling the bacteria shows that it is the pathogen causing cat scratch disease or CSD, an acute form of the infection. But like Lyme, this pathogen has been associated with complex chronic conditions spanning multiple body systems, including the joints, eyes, heart, and brain.

Lyme disease has made people fearful of ticks, but Bartonella can be transmitted by a long list of biting insects – or vectors – including fleas, body lice, sand flies, and even spiders. Also, an underappreciated risk factor for bartonellosis is animal exposure, particularly exposure to cats, which are natural reservoirs of the bacteria.

In a study of veterinary workers, 44% were positive for Bartonella antibodies, and 28% had DNA of the pathogen detected directly from their blood. With approximately 66% of U.S. households owning at least one pet, the pathogen has the potential to be more widespread than generally thought.

Dr. Ed Breitschwerdt from North Carolina State University’s veterinary school has studied Bartonella since the 1990s. The advanced testing methods developed in his lab by collaborator Dr. Ricardo Maggi have uncovered key links between the pathogen and complex illnesses, such as arthritis, chronic fatigue, and fibromyalgia.

Neuropsychiatric conditions

Recently, using innovations in advanced PCR technology, the lab has made groundbreaking discoveries linking Bartonella and neuropsychiatric conditions, such as schizophrenia.

The investigation into schizophrenia started the way many discoveries in medicine do, with one case. A 14-year-old boy – who we will call Michael – suffered from sudden onset psychosis and received a formal diagnosis of schizophrenia. Michael was referred to Dr. B’s lab because he had marks on his skin, called striae, consistent with a Bartonella infection.

Dr. B and his team used their advanced test methods to confirm that Michael was infected with Bartonella. Upon treatment with the appropriate antibiotics, his symptoms evaporated.

The case inspired Dr. Breitschwerdt to consider a hypothesis – what if other patients were experiencing psychosis because of a Bartonella infection? Bartonella can cross the blood-brain barrier and infect endothelial cells, contributing to neuroinflammation.

The hypothesis had merit. His lab partnered with the University of North Carolina to test 17 schizophrenia patients. Sixty-five percent of those patients tested PCR positive for the pathogen, compared to 8% in healthy controls.

A subsequent study with Columbia University on over 100 patients found that people affected with psychosis were over three times more likely to have direct evidence of Bartonella in their blood than unaffected controls.

PANS

And schizophrenia isn’t the only neuropsychiatric condition linked to the pathogen. Pediatric patients with Bartonella infections have been reported to develop Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and symptoms like anxiety, obsessive-compulsive disorder, and cognitive dysfunction. Case studies have shown improvement in neuropsychiatric symptoms following treatment of the underlying infections.

With over 3 million Americans battling schizophrenia and 1 in 200 children in the U.S. affected by PANS, Bartonella may emerge as the great hidden pandemic.

Babesia – the tip of the iceberg

Babesia is a tick-borne parasitic infection, often touted as similar to malaria, because both parasites infect and replicate within red blood cells and can cause fever, chills, sweats, headache, muscle aches, fatigue, and hemolytic anemia.

Researching Babesia on the CDC Website shows that under 2000 cases were reported nationwide in 2020. The CDC notes that most Babesia cases in the U.S. are caused by Babesia microti, with occasional cases caused by other Babesia species.

Using the same advanced PCR technology that drove clinical discovery in Bartonella, Dr. B and his team turned their attention to Babesia. They found that what we “know” about Babesia may only be the tip of the iceberg.

In 82 individuals the lab was studying for Bartonella infection, 22 (27%) were also infected with Babesia. Furthermore, the top Babesia species identified was not Babesia microti, as expected from CDC data, but rather Babesia divergens (considered rare in the U.S.) and then Babesia odocoilei (considered rare in humans).

Before Dr. B’s work, only a handful of case reports in the U.S. have ever been reported for Babesia divergens. Their best-in-class assay turned up 12 new cases in a group that wasn’t even targeted for Babesia studies.

Dr. B’s team also recently published a paper where an entire family – all five members and one of their dogs – tested positive for a Babesia-divergens-like species. Similar new case discoveries have been made for Babesia odocoilei. His work poses the question – are the pathogens really rare, or are we just not testing for them properly?

Genus versus species – why it matters

Genus and species are terms commonly used by microbiologists, but when I first entered the world of tick-borne disease, I didn’t fully understand their significance. The “genus” is akin to a family name, grouping related individuals – think Hatfields and McCoys. The “species” is like the first name, identifying a specific individual in the family.

Translating this to Lyme disease, Borrelia is the genus or family name, and Borrelia burgdorferi is the species name identifying the particular pathogen.

So why does it matter? The current commercial test methods for all three Bs generally use serology or antibody testing. These assays measure antibodies created by the host’s immune response to the pathogen. The problem is that antibodies react to proteins on the surface of the pathogen, and these proteins can vary depending on the particular species.

In other words, the patriarch of the Hatfield family, Anderson Hatfield, looked and dressed differently than his son Cap Hatfield. Thus, sending out a warrant and a picture of Anderson is unlikely to lead to Cap’s arrest.

Antibody testing is similar, and testing for Babesia microti, may not accurately diagnose a case of Babesia odocoilei or Babesia divergens. There are over 100 known Babesia species, with 15 of those confirmed in human cases.

There are over 50 species of Bartonella, at least 20 of which have been documented to infect humans and other mammalian hosts. Dr. B’s research and testing technology is redefining what we know about these pathogens. And until these tests are launched commercially, millions have the potential to be misdiagnosed.

Direct Detection for BBB is Launching at Galaxy Diagnostics

Fortunately, Galaxy Diagnostics was founded by Dr. Breitschwerdt, Dr. Maggi, and Dr. Amanda Elam to bring these diagnostic advancements to market. This month, Galaxy is launching its digital PCR, direct detection assay for BBB.

This assay has been instrumental in driving clinical discovery in Dr. B’s lab and will now be commercially available to practitioners. Top features of the assay include:

  • Genus level detection, detecting each pathogen regardless of species.
  • Ultra-sensitive, digital PCR, which increases detectability for low abundance pathogens.
  • Multiplexed detection to provide three results in a single test.

The BBB assay is a blood-based assay that detects the DNA of each pathogen. The approach has previously been used only in a research setting, but the team at Galaxy has now validated the assay for commercial use.

Bartonella and Babesia – but what about Borrelia?

The BBB assay is a blood-based approach, and it is essential to note that blood is NOT the best matrix for Lyme Borrelia, as I have discussed previously.

Galaxy recommends its urine antigen test for Lyme since the concentrations of Lyme Borrelia are so low in the blood that a blood draw is unlikely to capture the pathogen in the test tube. And no matter how sensitive the technique is, if the pathogen isn’t in the tube, there is no way to detect it.

So then, why is Borrelia included in the BBB assay? The answer goes back to the genus versus species issue. While the species associated with Lyme Borrelia often hide in tissues and don’t free-circulate in high copy numbers in blood, the species associated with Relapsing Fever Borrelia do replicate to high numbers in the blood.

As a result, combining the BBB assay with Galaxy’s Nanotrap urine antigen test for Lyme provides optimal coverage for the top flea and tick-borne infections at the genus level.

Coming Full Circle – Avoiding Cases like Russ

After my husband Russ passed, the engineer in me knew there had to be better options. I immersed myself in the research and found Dr. B’s published peer-reviewed results. I introduced myself to the Galaxy team, and as I dug in, I became even more convinced that their technology would provide the clarity I craved as a caregiver.

In June 2024, I became Galaxy’s CEO to bring these advanced testing techniques to a broader market. We crystallized our mission to provide a new standard of care for diagnosing these devastating flea and tick-borne diseases. With the commercial launch of the BBB assay, we are one step closer to that goal. I know that Russ is watching – and smiling.

Nicole Bell, CEO of Galaxy Diagnostics, is also the author of What Lurks in the Woods and The State of Lyme Disease Research. 

For more:

Category:

Babesia, Bartonella, Lyme, PANS, Testing, Ticks, Treatment

Prof. Holly Ahern’s Lyme Disease Comments to Australian Senate

https://www.lymedisease.org/holly-ahern-australian-senate/

Prof. Holly Ahern’s Lyme disease comments to Australian Senate

2/5/25

The Australian Senate has launched an inquiry into the access to diagnosis and treatment for people in Australia with tick-borne diseases. Professor Holly Ahern of the United States recently submitted the following written comments and was also asked to give verbal remarks. (See video at end of this article.)

Dear Committee Members:

I am a scientist, professor of microbiology, and co-founder of a Lyme disease advocacy organization in New York State. I am also the Scientific Advisor for the Focus on Lyme Foundation in Arizona, which has funded research on several projects directed at improving the state of diagnostic testing for Lyme disease and other tick-borne illnesses.

I have served on several state and federal committees convened to address the growing problem of tick-borne diseases in the United States, most recently the 2022 Dept. of Health and Human Services, Tick Borne Disease Working Group (TBDWG).

But most of all, I am mother of a daughter who went from a record setting collegiate All American swimmer to bed bound and disabled over the course of only a few weeks. She lost years of her life as a result of flawed medical guidelines that prioritize care for patients early in the infection, while providing only minimal guidance for the diagnosis and care of patients in later stages of the disease.

In my daughter’s case, we saw the tick bite but she developed no rash. Fever, profound fatigue, widespread pain, and other symptoms began months later, and were attributed to a viral illness. The difficulties we faced in getting her illness diagnosed and appropriately treated in 2010 match those of hundreds of thousands of other people with Lyme disease in the United States and Europe, and also in Australia.

Biologically complex organism

Lyme disease is a bacterial infection caused by a microbe with global distribution. They are transmitted to humans by several species of tick. The bacteria are biologically complex. They adapt and survive in environments that would kill most other bacteria.

During human infection, some subgroups (genospecies) of these bacteria linger in the bloodstream, while others disseminate to connective tissue-rich areas of the body. Regardless, infection triggers profound immune system and other physiological events, leading to a wide range of symptoms that vary significantly among patients and can be quite severe.

The standard medical definition implies that the overwhelming majority of Lyme borreliosis (Lyme disease) patients are infected with the same bacteria and have the same uniform disease presentation, which is straightforward to diagnose and treat. As defined, Lyme disease is caused by only a few specific genospecies of Borrelia (now named Borreliella). Several other genospecies of Borrelia are associated with diseases collectively referred to as “Relapsing Fever borreliosis.”

Differences between the two diseases are subtle. Relapsing Fever Borrelia fail to produce the skin manifestation (erythema migrans or “bull’s-eye” rash) that is noted in Lyme disease; however, other symptoms are very similar. Existing diagnostic tests for Lyme disease don’t detect infections caused by Relapsing Fever Borrelia.

Thus, a patient may be bitten by a tick and infected with a Relapsing Fever Borrelia, such as B. miyamatoi, show all the symptoms that a patient with Lyme disease would have, but may not be diagnosed or treated for the infection because the EM rash did not appear and/or the standard lab tests for Lyme disease were negative.  (See link for article)

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For more:

Category:

Lyme, research, Testing, Ticks, Transmission, Treatment

Complex Role of Bartonella in Chronic Illness #1

https://www.lymedisease.org/med-detective-bartonella-part-1/

MEDICAL DETECTIVE: The complex role of Bartonella in chronic illness, part 1

This article was originally posted on Dr. Richard Horowitz’s Medical Detective Substack. It is Part 1 of a 5-part series. You can find more helpful content by subscribing here. 

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.

[From: Mazur-Melewska K, Mania A, Kemnitz P, Figlerowicz M, Służewski W. Cat-scratch disease: a wide spectrum of clinical pictures. Postepy Dermatol Alergol. 2015 Jun;32(3):216-20. doi: 10.5114/pdia.2014.44014. Epub 2015 Jun 15. PMID: 26161064; PMCID: PMC4495109.]

Unfortunately, Bartonella infections rarely resemble this one particular manifestation, or the general medical community would be diagnosing and treating it a lot more often.

It is a very tricky bacteria, and, like Lyme disease, has found a way to not only avoid immune recognition, but change its clinical characteristics so it resembles a broad range of other diseases.

Immune Evasion by Bartonella

Bartonella is referred to as a “stealth bacteria” because it evades the immune system by living inside red blood cells (intraerythrocytic persistence), blood vessel walls (inflaming them, causing vasculitis), endothelial cells, fibroblasts, epithelial cells of the skin (causing the classic Bartonella rashes described below), macrophages (immune cells that play a critical role of initiating and maintaining an inflammatory response, as well as potentially resolving inflammation) and bone marrow cells.

So it can hide throughout the body in areas where the immune system doesn’t easily penetrate and recognize the bacteria, not to mention, it can exist under biofilms in persister forms like Borrelia. Biofilms protect the bacteria from immune recognition and the effects of antibiotics.

[From: Okaro, U.; George, S.; Anderson, B. What Is in a Cat Scratch? Growth of Bartonella henselae in a Biofilm. Microorganisms 2021, 9, 835. https://doi.org/10.3390/microorganisms9040835%5D

Bartonella can manipulate host cell interactions to hide from immune detection by altering its surface proteins to avoid recognition (like Lyme disease), and possesses unique fat and sugar molecules (lipopolysaccharides) that minimize immune response activation; this often leads to prolonged, asymptomatic infections that can be difficult to diagnose with standard tests (it can hide in the body for years in some patients without symptoms), and then reactivate under certain conditions.

The patient below was in remission for one year after doing an 8-week course of double dose dapsone combination therapy (DDDCT), and then reactivated after being treated with antibiotics for a skin infection. This skin rash emerged when he got treated for cellulitis, which had nothing to do with his initial Lyme infection. You can see the classical Bartonella “stretch marks.”

[From: Horowitz, R.I.; Fallon, J.; Freeman, P.R. Comparison of the Efficacy of Longer versus Shorter Pulsed High Dose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome with Bartonellosis and Associated Coinfections. Microorganisms 2023, 11, 2301. https://doi.org/10.3390/microorganisms11092301%5D

Reactivation often happens when the immune system is unable to control the infection, due in part to the immunosuppressive nature of the bacteria.

I’ve found multiple species of Bartonella in our sickest patients leading to chronic variable immune deficiency (CVID), just as I’ve found Borrelia causing immune suppression, along with mold toxicity and Long Covid affecting immune functioning.

The multisystemic nature of Bartonella infections

When we see patients with Bartonella, as I mentioned, it has no resemblance whatsoever with the classical cat-scratch disease I learned about in medical school. Bacteria like Bartonella cause similar symptoms to those seen in chronic Lyme disease, presenting as a “great imitator.”

It can result in chronic fatiguing, musculoskeletal, cardiopulmonary, neuropsychiatric illness and can cause fevers, chills, fatigue, headaches, muscle/joint and nerve pain, cognitive difficulties, insomnia, depression, anxiety, and cause inflammation in every body system imaginable, just like Lyme disease, Borrelia burgdorferi, does.

There can also be inflammation in the eyes (optic neuritis, conjunctivitis, uveitis, arterial and venous occlusions); the brain, surrounding structures and spinal cord (meningitis, encephalitis, transverse myelitis, seizure disorders), with associated Bartonella “rage” and psychosis (Bartonella, like Lyme disease, can cause a broad range of psychiatric manifestations, including but not limited to severe depression, anxiety, Obsessive Compulsive Disorder, Bipolar disorder and schizophrenia with psychosis).

It also can cause inflammation in the muscles (myalgias), joints (arthritis, osteomyelitis), nerves (neuropathy) and blood vessels (vasculitis), as well as the heart valves (endocarditis, including culture negative endocarditis), heart muscle (myocarditis), and sac surrounding the heart (pericarditis) causing chest pain with masses in the chest (mediastinum) and lymph nodes resembling non-Hodgkins lymphoma.

Even the gastrointestinal tract can be affected (nausea, vomiting, weight loss, bleeding), as can the liver (hepatitis), spleen (splenitis, enlargement), and skin, which oftentimes shows signs of inflammation (stretch marks, i.e. striae; granulomas, hard fibrous areas over the knuckles, elbows, and Bacillary angiomatosis, which are tumor-like masses, raised dark areas, papules, nodules, and lesions in the skin, bones, and organs).

Bartonella is a frequently found infection in those suffering from chronic Lyme disease—I’ve seen it in up to 80-90% of all of my chronically ill patients these days and should be considered in any and all cases of FUO (fever of unknown origin).

[From: Cheslock, M.A.; Embers, M.E. Human Bartonellosis: An Underappreciated Public Health Problem? Trop. Med. Infect. Dis. 2019, 4, 69. https://doi.org/10.3390/tropicalmed4020069%5D

Transmission of Bartonella

Part of the reason Bartonella has been a controversial topic in the Lyme community–at least among certain physicians and researchers–is because there has only been one study to date regarding tick transmission of the bacteria, and this was in European species of deer ticks (Ixodes ricinus) with one species, called Bartonella birtlesii.

The bacteria is, however, being found in ticks throughout the world, and other studies have shown the bacteria in different ticks and in chronic Lyme disease patients.

When I was co-chair of the HHS Tick-borne Disease Working Group (TBDWG) back in 2018, I had to fight to get Bartonella included as a co-infection of importance; whether all species are able to be transmitted by ticks or not, makes no difference.

Why? To date, the number of species able to transmit Bartonella keeps increasing over the years, and most of us are exposed to these vectors on a regular basis. The most common vectors transmitting the bacteria are fleas, mites, lice, keds (not the sneakers!), spiders, red ants, ticks (probable), sand flies, black and yellow flies, and mosquitoes.

Bartonella is showing up in a broad range of vectors, so it’s possible to get exposed from many different sources. That is why the vast majority of my sick patients are testing positive for it. In fact, for most of us living on this planet, I daresay we’ll all likely be exposed to Bartonella at some point during our lives. How we handle it, and whether we get symptoms, will depend on how our immune system is functioning.

Testing for multiple Bartonella species

The table below shows some of the most common species of Bartonella seen in human disease. This is not comprehensive, as there are now at least 45 species of Bartonella, and 18 of them or more are pathogenic [capable of causing disease].

Some of the most common ones are: B. henselae (Cat scratch disease, CSD; endocarditis, neuroretinitis, lymphadenopathy), B. quintana (Trench fever, endocarditis, bacillary angiomatosis [BA]), B. clarridgeiae (bacteremia, endocarditis, CSD, chest wall abscess), B. elizabethae (endocarditis, neuroretinitis),  B. bacilliformis (Carrion’s disease), B. koehlerae (endocarditis, including culture negative endocarditis), B. vinsonii subsp (bacteremia, endocarditis, fevers, neurological symptoms), B. berkhoffi (endocarditis, bacteremia, neurological symptoms), and B. grahamii  (neuroretinitis).

[From: Rebekah L. Bullard, Emily L. Olsen, Mercedes A. Cheslock, Monica E. Embers, Evaluation of the available animal models for Bartonella infections, One Health, Volume 18, 2024,100665, ISSN 2352-7714, https://doi.org/10.1016/j.onehlt.2023.100665.%5D

How do we test for Bartonella?

As you can see from the above table, testing for just one species makes no sense, because we can be exposed to a broad range of Bartonella species during our lifetime. I started to test for Bartonella over two decades ago. This is from an abstract I presented at the 16th International Scientific Conference on Lyme disease in 2003:

You can see from this abstract, even 22 years ago, by just testing for Bartonella henselae, one of the most common species, we found that using an ELISA and IFA (Immunofluorescent Assay) was positive in less than 50% of patients–but using DNA analysis with a PCR (Polymerase Chain Reaction) in the blood, we found 53% were positive when standard antibody assays were negative.

Which means the rule of thumb when testing for Bartonella is go as broad as you can. It is fine to start with local lab testing.

Level 1 testing

Using local labs like Quest, Labcorp, or Bioreference, you can send off antibody titers to B. henselae, B. quintana and B. bacilliformis, as well as PCRs and even a VEGF (vascular endothelial growth factor), an indirect marker of Bartonella exposure, indicating inflammation in the blood vessels (vasculitis). Often, however, you’ll want to use several specialty labs to prove infection.

Level 2 testing

If the above testing is negative, as it usually is, but you clinically suspect Bartonella, move on to the next level of tests. The three specialty labs include IgeneX laboratory (Bartonella IgM/IgG Immunoblots, Bartonella FISH [Fluorescent In-Situ-Hybridization test, an RNA test], T Labs (Bartonella FISH) with confocal microscopy, and Galaxy Laboratories, using their 4 species IFA antibody panel (for the most common species), and their ddPCR (direct droplet PCR) tests. The Bartonella Digital ePCR™ platform combines highly sensitive ddPCR technology with culture enrichment (BAPGM™).

I usually start with IgeneX laboratory and find that most of my patients have indeterminate or positive Immunoblots. Many times a negative Bartonella FISH test will turn positive later on during treatment, after the bacteria has been flushed out from the intracellular compartments where it’s been hiding.

I follow VEGF levels over time, as an indirect marker of Bartonella, when reactivation of infection is suspected. Keep in mind VEGF can be positive for other reasons (including Long Covid or cancer with metastases).

Level 3 testing

Skin biopsies can be done of the classical Bartonella rashes. Dr. Marna Ericson from T Labs has done this for me several times, and she found positive Bartonella in the skin, under biofilms, when it couldn’t be found through other methods.

I suspected Bartonella in two of my patients, but despite all classical testing, couldn’t prove exposure. The Bartonella fluoresces red under the microscope with this technique. I don’t suggest it as first level testing, but it can be very useful if you have looked for Bartonella using any and all of the above laboratories and methodologies.

Stay tuned for parts 2, 3, 4 and 5

In Part 2, I’ll discuss more about establishing a diagnosis as well as an overview of how other co-infections may overlap and affect Bartonella symptoms. Part 3 will discuss effective treatments, and Parts 4 and 5 go into more detail about these treatments.

Dr. Richard Horowitz has treated 13,000 Lyme and tick-borne disease patients over the last 40 years and is the best-selling author of  How Can I Get Better? and Why Can’t I Get Better? You can subscribe to read more of his work on Substack or join his Lyme-based newsletter for regular insights, tips, and advice

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Babesia, Bartonella, Lyme, Psychological Aspects, research, Testing, Ticks, Treatment