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Bartonella: The Epidemic You’ve Never Heard Of, Part 3

Flea collar! Stat!

This is the final installment of a three-part series on Bartonella, bacteria that are being linked to a wide variety of ailments – many of them chronic, and some of them life-threatening. In part one, we talked about what Bartonella is, and its growing recognition as a potentially wide-ranging and serious infectious disease. Part two covered the wide array of transmission vectors and illnesses associated with the bacteria. Part three will review the current state of the research and recommendations for the future.

This past April, NC State University hosted the 7th annual international conference on Bartonella as human and animal pathogens. Over the course of the four-day conference, medical professionals and researchers from around the world gave presentations on topics ranging from rates of Bartonella infection in healthy dog and cat populations, to close examinations of the morphology, or structure, of Bartonella inside cells.

A lot of the research presented dealt with the main issue that confronted Ed Breitschwerdt when he first began looking closely at Bartonella – the stealthy nature of the pathogen and its ability to conceal itself within the human body, even while causing repeated illnesses.

Dr. Lesley Ann Fein, a rheumatologist who attended the conference, offered a very nice summary of both the conference and its implications for future research:

Bartonella bacteria are highly evolved, survive in multiple insect vectors and in dessicated flea feces, and enter our bodies in a stealth-like manner, switching off our immune response as it takes residence in our tissues.

“It persists despite aggressive treatment and is clearly a contender for diseases transmitted by blood transfusions. Physicians must be cognizant of the stealth nature of this pathogen and the alarmingly high frequency of seronegativity.”

Ed Breitschwerdt agrees. “We need to understand more about the way this bacteria functions in the human body – how and why it is so successful at hiding and causing persistent infections. We also need to get the word out to the medical community about this pathogen. Just knowing what to look for may end up giving patients with unexplained chronic illnesses better treatment options.

“In my opinion, bartonellosis, caused by the diverse members of the genus Bartonella, may prove to be the most important emerging infectious disease of the next decade.”


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  1. For Dawn Lacy, and so many others with severe Bartonella infections, getting an accurate diagnosis and effective treatment may be one of the biggest challenges you will ever face. (With the experience of dealing with a severe Bartonella infection for many years, maybe I could be of some help. Feel free to contact me, If one is able to get treatment, like Teresa has, it appears that the treatment is often misguided. For those with Bartonella, our health care system is beyond being broken, for many it barely exists. If you think you have Bartonella, it would be best to figure you are on your own, and it is vital you know as much as possible about the Bartonella bacteria, and the issues that need to be addressed in order to provide for successful treatment.

    The best medical literature can help guide you, but much of it simply does not apply to our current understanding of Bartonella, or is just plain wrong. You will find that the most effective treatment, particularly for those with chronic Bartonella, is not known, but many people do recover with the treatments being used. You need to know everything about those treatments and the potential side effects of the antibiotics being used. Always fact check and research anything a doctor says or recommends. You may find that doctors are just as human as the rest of us, and that they make lots of mistakes.

    Overall, consider the treatment issues. With the Bartonella bacteria being inside the cells, it is most vulnerable to antibiotics when outside the cell during replication. Most bacteria replicate quickly. Bartonella replicates every 22 hours. Anytime in 22 hours that effective antibiotic plasma levels are not maintained in the blood, the Bartonella may be able to continue to replicate. To address that issue we have to try to use antibiotics that maintain effective plasma levels. Look at the half-life numbers for various antibiotics to see how long they persist in your blood.

    It would be important to use antibiotics that have good intracellular penetration, and that will provide effective treatment against the Bartonella while inside the infected cells, but what are they? We need research to find that out.

    Then there are the very difficult brain issues, when the Bartonella infects the central nervous system. While mainly in the vascular system, Bartonella can also infect brain tissue, even to the severity that fatalities have occurred in otherwise healthy children when Bartonella infected their brains. What antibiotics, effective against Bartonella, can pass through the blood brain barrier and be effective in the brain? Look at the cerebrospinal fluid penetration (CSF) percentages for various antibiotics, but they can be very misleading, as that only gives us some information on the entry of the antibiotic to the vascular system in the brain. You need to also search each drug for brain tissue penetration studies if you believe the infection has gone beyond the vascular system and infected brain tissue. For example, rifampin has about 50% CSF penetration, but very poor brain tissue penetration. Moxifloxacin has lower CSF penetration, but penetrates brain tissue extremely well.

    To top it off, there are drug resistance problems to consider. Research has demonstrated that Bartonella can develop resistance to azithromycin rapidly, as well as all the macrolide drugs. There are studies indicating that there is the potential for drug resistance issues for most of the drugs being used to treat Bartonella, except for doxycycline. Drug resistance is always an issue to keep in mind. Overall, while Bartonella is a different kind of bacteria, the treatment issues are very similar to those involved in treating tuberculosis.

    It is for good reason that the research indicates that we should always use a combination of antibiotics when treating Bartonella. (With tuberculosis it is a combination of four.) How else can you address all those treatment issues, particularly when there is so much we do not know? Worse still is that there is so much your doctor may not know, and it can be very difficult trying to present doctors with the information they need to guide them in providing you with responsible treatment options.

    Effective treatment requires some serious thinking. I have been trying to get it right for close to three years. After years of antibiotic treatments that have been effective for some people, I am still sick. This spring, just two weeks after antibiotics were discontinued, a very severe, long term relapse had begun. Blood taken at that time provided a positive Bartonella PCR test result from testing done by the Galaxy Diagnostics lab. The antibiotic treatments simply were not effective. Why? There are a number of reasons to explain the treatment failure. Simply put, it appears that the properties of the antibiotics that were used may not have adequately addressed all the important treatment issues.

    As far as the diagnosis, realize that there is no such thing as a negative Bartonella test. Testing can only confirm a clinical diagnosis. Studies indicate that the standard Bartonella testing accuracy may be as low as 18%. Tragic if your doctor does not know that. While costly, for both you and them, Galaxy Diagnostic’s highest priority is to provide the most accurate Bartonella testing. They do, but be aware that even they get false negatives, and even their testing can only confirm a clinical diagnosis.

    It is very important, if you are able to find an effective treatment, and achieve a recovery, to continue treatment well beyond the resolution of symptoms. Bartonella is notorious for relapsing after treatment, regardless of negative test results. In the worst case, when doctors made the mistake of stopping effective Bartonella treatment too soon, it proved to be a fatal mistake for the patient. That should be a lesson to all doctors who would restrict treatment options for their patients. Recovery may require treatment to continue for up to a year or more, and if years of treatment are not effective, try to figure out why and keep trying.

    What combination of antibiotics will be effective for the most severe, chronic, and treatment resistant Bartonella infections? That is still an open question.

    For Dawn, if dealing with a severe Bartonella infection is not bad enough, having to deal with poorly informed doctors in your efforts to get effective treatment, can make you feel even worse. Even the leading medical teaching Universities I contacted were of no help. The one doctor who has consistently tried to help me, and whose guidance may result in my recovery, is Dr. Edward Breitschwerdt. To him, I am just a sick stranger writing emails asking for help, but he has consistently responded. This spring he provided generalized guidance regarding Bartonella treatment issues, and the properties of the antibiotics that might be most effective. This is invaluable information that could be used by medical providers in determining the best treatment options. Unfortunately I have not found even one doctor who will take his advise seriously, so I have gotten various physician’s antibiotic reference books, and I have been doing research on the web trying to determine what antibiotics best address those treatment issues.

    In conclusion, for those with a severe Bartonella infection, it might be an understatement to say that it can be extremely difficult to get the effective treatment needed to restore your health. On the other hand, it will be quite and accomplishment if you can figure it out.

    1. hey James I read your very thorough comments re Bartonella, how have you improved since 2012 ? I truly hope you have, what was the best course of treatment ? were your arms and legs swollen ? Did you have high blood pressure below I left my email if you respond please send me the email directly, I don’t get to these chat rooms often

  2. I was bitten by a feral cat and have suffered tremendously with multiple and complex physical and neurological symptoms which have progressed to frequent seizures. Every indication points to Bartonella. However, the doctors in my rural area are so unfamiliar with the disease that nobody is willing to attempt treating me. I’m in a desperate situation and need to find a doctor able to help. Any guidance would be greatly appreciated!

  3. I went through a SEVERE cognative illness where I could not even function. After being told I was crazy, I had testing done for Lyme and co-infections. Band 41++ and 34++ (Kda 41 & 34) Yale has a PATENT on band 41 stating “it does NOT crossreact with any other flagella so it is a excellent indicator of Borrelia b. I also tested POS for Bartonella. Active infection. Dr Jemsek of “under our skin” movie fame put me on 600mg Omnicef, 1000 mg Azithromyacin and 200mg Minocyn every other day (cyclical). HUGE improvement. I also am taking 100 BILLION probiotics and numerous nutracells a day for immune suppression problems. People with severe issues need to look into Infectious Mycoplasma infection as a coinfection. Google IMMED or Prof Garth Nicolson. THNX, Dr Ed for your wonderful work and getting the word out on this.

    Brian Burkett

  4. I was just diagnosed with CSD. I volunteer with a cat shelter and recently we had to bathe some of the cats in addition to their spot treatment to combat fleas,and got a nasty scratch to the right wrist that did not heal well.
    Almost a month later,the soles of my feet are tender,my joints hurt and I have a huge sore area under right armpit.I am feverish,tired and foggy minded and I am actually wheezing bad.My physician prescribed Augmentin and Prednisone, let’s hope it works,this is week one of two weeks of meds.I am still kicking myself for not cleaning it promptly.

  5. Teresa, I would like to hear more about your zithro treatment.
    I also did zithro in Mesa, Az. I was not Dr Fry patient.
    My doctor was Dr David Korn at his place. Long Life medical.

    It was IV and first I think it was EDTA chelation ( or something chelation for over an hour) and then 500 mg of zithro.

    It was 3 times a week with no other abx. There were other younger patients that were given daily doses of zitho pill for also but not me.

    I believe Dr Korn was trying to go slower with me.

    Also he put me on heparin injections because of very thick blood.

    Where were you treated.

  6. HI, I have tested positive for Bartonella through Fry Laboratories. My Lyme Literate doc put me on Zithromax for the infection. Just thought I’d pass this along. I would be happy to be contacted for follow up if you’d like to know my Bartonella infection responds to this treatment. Feel free to contact me.
    Teresa Young

    1. Hi Teresa,
      How did you do with your Bart treatment? Were you able to eradicate it?? Please let me know, I’m taking 2 others abxs and would love to know is Z worked for you.

  7. To Bartonella researchers,

    If anyone has some ideas on what drugs might be effective in the most treatment resistant Bartonella, I would like to try them. Having tried aggressive combinations of most of the regular drugs, (not chloramphenicol or gentimicin) I have had severe relapses in two weeks after stopping treatment with a positive PCR last time. The worst part of the relapses are terrible mental torment that turned into strange seizures once. Starting treatment again reduces the symptoms, but it seems that the bacteria persists in the brain.

    I would be willing to try most anything that might help if someone wants to experiment. Aside from rifampin, would other TB drugs help? What else is out there that might work? This can be a terrible illness, and to find a more effective treatment would be quite an accomplishment. If anyone wants to try, I will be a willing test subject. Thank you for your consideration.