Bartonella - worsening of symptoms after 2.5 months of treatment

General
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1

Dear all,

I have a question with respect to bartonella, which was found in my blood sample (no borreliosos was found). I have now been treated for 2.5 months with a combination of antibiotics - clindamycin and rifampin taken twice a day. At the beginning I felt really good, my mostly neurological symptoms improved and I felt really positive about the treatment. It could have been a coincidence because around the same time I started taking a new, potent, antidepressant (venlaflaxine), which is also used in the treatment of pain. 2.5 months on and I feel the worst pain I've had in the past year. What's worse, it seems to be all over my head not just my jaw joints and teeth like before I started the antibiotics. I can only guess if it's the weather changes making me worse or if it could be that the antiboitics are no longer working? According to most doctors where I live, bartonella doesn't even take that long to treat, so I should be ok by now.

I will be happy to hear your thoughts and experiences.

Thank you,

Oli

2

I would tend to agree with your assesment.

Here the thing Bartonella without borreliosos is an entirely different thing. Until around 15 years ago, only three human diseases were recognized as clearly attributable to Bartonella organisms: cat scratch disease (CSD, also sometimes referred to as cat scratch fever), caused by B. henselae; Carrion's disease, caused by B. bacilliformus (and limited to South America); and trench fever, caused by B. quintana. More recently, however, additional pathogenic Bartonella species have been discovered but the method of tranmission has not. The only one that comes from ticks to humans is B. henselae. Most often its by a flea bite or the scratch of a cat. Cat bites may be implicated as well. A week or so after exposure, a papule forms at the transmission site and then usually develops into a pustule. In immunocompetent people, the systemic symptoms of cat scratch disease are usually limited to regional adenopathy, though it can also cause fever and, more rarely, eye disorders, hepatosplenic infection, osteomyelitis, and encephalopathy.

Bartonella is sensitive to many different antibiotics in vitro, but the in vivo performance of these antibiotics in humans and domestic pets does not correlate well with in vitro laboratory studies. Most likely, this stems from two factors: 1) almost all antibiotics are bacteriostatic against Bartonella, rather than bactericidal; and 2) the pathogen is often sequestered in erythrocytes.

Cat scratch fever usually resolves even without treatment, and there is little evidence that antibiotics shorten the duration of the disease. Thus, there is disagreement over whether or not antibiotic treatment is even necessary for uncomplicated CSD. Tick-transmitted Bartonella may be a more serious matter, however, since the possibility of co-infection is always present. In addition, there is general agreement that the presence of B. henselae in cerebrospinal fluid, whatever its origin, warrants treatment.

Cat Scratch is most often treated with tetracyclines, macrolides or aminoglycosides. For CNS infection, antibiotics that cross the blood brain barrier are necessary, and combination therapy is usually recommended, as it may have more efficacy. Among the recommended regimens are azithromycin or doxycycline in combination with rifampin, clarithromycin or a fluoroquinolone. (which of course is far different than what you recieved)

I guess what I am saying is that from where I am sitting your docs are barking up the wrong tree. I would be working with a neurologist. The "blood test" you had which simply was looking for DNA has no way of determining what you have.

EVERYBODY is likley to have some form of Bartonella.

3

Many thanks for your reply, tj1. Over the couple of years I have been seeing my neurologist I received about 3 different diganoses (atypical trigeminal neuralgia, atypical odontalgia, atypical facial pain...). MRI and a cat-scan don't show any lesions on my brain or anything of that sort. It all started with a dental procedure but now I am puzzled as to why the whole head seems to be involved. The blood work I had done was quite thorough (at least from what I can tell) and it showed some signs of infection in my body (not serious though), active helicobacter in my stomach (quite common), some past bacterial infections my body had dealt with successfully and the bartonella. I think if it wasn't for the serious neurological problems I have at still a relatively young age (I am 35 and had problems for the past 3-4 years), I would have been considered healthy and I wouldn't even be treated for the bartonella. Like you said, it seems to be a very common infection among people.

Thank you and best,

Oli

tj1 said:

I would tend to agree with your assesment.

Here the thing Bartonella without borreliosos is an entirely different thing. Until around 15 years ago, only three human diseases were recognized as clearly attributable to Bartonella organisms: cat scratch disease (CSD, also sometimes referred to as cat scratch fever), caused by B. henselae; Carrion's disease, caused by B. bacilliformus (and limited to South America); and trench fever, caused by B. quintana. More recently, however, additional pathogenic Bartonella species have been discovered but the method of tranmission has not. The only one that comes from ticks to humans is B. henselae. Most often its by a flea bite or the scratch of a cat. Cat bites may be implicated as well. A week or so after exposure, a papule forms at the transmission site and then usually develops into a pustule. In immunocompetent people, the systemic symptoms of cat scratch disease are usually limited to regional adenopathy, though it can also cause fever and, more rarely, eye disorders, hepatosplenic infection, osteomyelitis, and encephalopathy.

Bartonella is sensitive to many different antibiotics in vitro, but the in vivo performance of these antibiotics in humans and domestic pets does not correlate well with in vitro laboratory studies. Most likely, this stems from two factors: 1) almost all antibiotics are bacteriostatic against Bartonella, rather than bactericidal; and 2) the pathogen is often sequestered in erythrocytes.

Cat scratch fever usually resolves even without treatment, and there is little evidence that antibiotics shorten the duration of the disease. Thus, there is disagreement over whether or not antibiotic treatment is even necessary for uncomplicated CSD. Tick-transmitted Bartonella may be a more serious matter, however, since the possibility of co-infection is always present. In addition, there is general agreement that the presence of B. henselae in cerebrospinal fluid, whatever its origin, warrants treatment.

Cat Scratch is most often treated with tetracyclines, macrolides or aminoglycosides. For CNS infection, antibiotics that cross the blood brain barrier are necessary, and combination therapy is usually recommended, as it may have more efficacy. Among the recommended regimens are azithromycin or doxycycline in combination with rifampin, clarithromycin or a fluoroquinolone. (which of course is far different than what you recieved)

I guess what I am saying is that from where I am sitting your docs are barking up the wrong tree. I would be working with a neurologist. The "blood test" you had which simply was looking for DNA has no way of determining what you have.

EVERYBODY is likley to have some form of Bartonella.

4

Have you had a spinal tap and culture?

5

No, I haven't...no doctor has offered it as option. Do you consider it important that I have it done? I am seeing my immunologist in a couple of weeks (the one who prescribed the antibiotics), perhaps I could ask him for a referral.