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Bartonellosis: Diagnosing a Stealth Pathogen

Ed Breitschwerdt.

NC State professor of veterinary internal medicine Ed Breitschwerdt has spent the last couple of decades working with Bartonella, bacteria historically associated with “cat scratch disease.” Bartonella is increasingly recognized as a cause of persistent intravascular infection that can result in severe health effects. Research from Breitschwerdt’s laboratory and others has led to the discovery of more than 30 new Bartonella species, as well as numerous chronically infected animal “reservoirs” for the bacteria and a variety of insects that can transmit Bartonella to both humans and animals.

Bartonella species are “stealth pathogens” – that is, bacteria that can survive undetected for years in the human body. These bacteria infect red blood cells, but can also live in the endothelial cells – the cells that line blood vessels and organs. Because Bartonella species can survive for such a long time within the blood stream and tissues, the symptoms of bartonellosis can take very divergent paths, resulting in “nonspecific” symptoms and an infection that is quite difficult to diagnose, let alone treat.

“We may be missing an epidemic,” Breitschwerdt says, “because even when you know where to look for this pathogen, it is still difficult to find.” To that end, Breitschwerdt believes that educating physicians, veterinarians and medical researchers about the way that Bartonella behaves across animal species may be one route to improving awareness and understanding of the diseases associated with these bacteria.

“We see diseases like endocarditis (inflammation of the cells lining the heart valves) occurring across animal species with these bacteria,” Breitschwerdt says.  “We’ve also found evidence of bartonellosis in the lymph nodes of cats, dogs, humans and other animals. It occurred to me that if you want to prove a link between persistent Bartonella infection and specific diseases, you should determine if a common pathology is shared across infected animal species. If researchers can document cross-species links, then clinicians and medical researchers would have more support for causation, which is very difficult to prove with stealth pathogens.”

In fact, Breitschwerdt and colleagues have proposed that a new postulate be added to Koch’s Postulates, a series of criteria that scientists refer to when determining whether or not a pathogen causes a disease. The proposed new postulate of comparative infectious disease causation appears in the Journal of Comparative Pathology. According to Breitschwerdt, “This new postulate further supports a One Health approach to the diagnosis, treatment and study of diseases that affect animals, including human beings.

“I think that we can learn many important lessons from the genus Bartonella – most importantly that these bacteria function as stealth pathogens, and contribute to complex disease expression,” Breitschwerdt continues. “Through this postulate, we’re proposing that researchers study naturally occurring animal models – including humans – to better understand the ability of an organism to cause disease. I think that this approach will be useful in studying numerous infectious and noninfectious diseases going forward.”

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  1. Not looking for medical advice but I was bit severely by a cat years ago that was usually friendly. It died a week later.
    I became sick with a strange illness that no one could diagnose not to long after I was bit by that cat. Never been tested for bartonella but from what I’ve read recently about this microbe I have so many symptoms consistent with this infection. Could this microbe live in my body for 20+ years? Totally disabled with migratory joint pain and neurological problems from severe tinnitus, photophobia and also bottom of feet so painful in mornings I went and bought diabetic socks. Any thought greatly appreciated.

    1. Glenn did you ever get a response from anyone on this? I’m not a doctor, but I’ve been diagnosed with Lyme disease and Bartonella, and your symptoms are classic symptoms of these diseases. You need to find a Lyme literate doc in your area (they are different from regular doctors or infectious disease doctors). All the best to you.

      1. I am suffering with symptoms of Lyme and Bartonella for 4 years now. I had one lyme test which was negative, which I heard is common. Since then symptoms are worse, especially the pain in my feet. Excruciating pain in feet, especially as the day gets later. How much does it cost to see a Lyme doctor? Can you have Bartonella without Lyme? I am having debri, or what looks like spores continually oozing from my feet. How do you stop this? Can’t take it anymore.

  2. can I still raise a question??. Do you know of a bloodtest with the use of a microscope Dark-field and/or Phase-contrast? where, if yes? koolsbergen

  3. It was determined by my doctor a couple of years ago that I had Bartonella that came from a bad cat scratch 30 years ago. He treated me for it. I suffer from Fibromyalgia, Chronic Fatigue syndrome and other issues. Do you think that this could still be causing me problems? If so, what would you suggest for my “next step”. I would so love to be well!
    Thank you,