posted 07 May 2002 18:09            

Anyone? THANKS! It has to be a ONE page handout.. so I can't add more unless I take out stuff...

BARTONELLA ALERT

It is well known that co-infections may occur with Lyme Disease relatively frequently. Patients with a
history of Lyme Disease who have incomplete resolution of symptoms should be evaluated for Bartonella
infections. Bartonella is an intracellular, gram-negative bacteria that can become chronic. Certain lab tests
may not detect the infection due to a variety of strains and the lack of sensitivity of the tests. It is advised to
use both PCR and IFA methods of testing and not to dismiss the disease due to negative tests when
symptoms are present. Various Bartonella species have been recognized since the early 1950’s.

Bartonella may not present in its usual form when additional infections, such as Lyme or Babesia are
present. In addition, typical Bartonella lesions are not always seen in patients, therefore, a diagnosis of
“fever of unknown origin” should alert a physician to consider Bartonella. It is estimated that approximately
2/3 of the patients with Bartonella have a fever. Involvement of practically every organ has been reported.

There are a variety of symptoms associated with Bartonella, including, but not limited to, the following:

GENERAL: Fatigue, Restlessness, Combative behavior, Myalgias, Malaise, Liver and/or Spleen
involvement, Abdominal pain, Infectious Mononucleosis-like Syndrome, Granulomatous Hepatitis

BRAIN: Encephalopathy may occur 1-6 weeks after the initial infection and is fairly common in patients
with Bartonella. Note: Approximately 50 percent of patients who develop Encephalopathy can be affected
by seizures (from focal to generalized, and from brief and self-limited to status epilepticus). Headaches,
Cognitive Dysfunction, and CNS Lesions may be evident.

RASH AND LYMPHADENITIS: Erythematous papules (red splotches or slightly raised red spots) may
develop. Such papules occasionally occur on the lower limbs but are more common on the upper limbs, the
head, and neck. The papules may appear on the skin or mucous membranes. Bartonella may also cause
subcutaneous nodules, with some bone involvement possible. The nodules may show some
hyperpigmentation, be tender, fester, and/or be enlarged or swollen, but not always.

EYES: Conjunctivitis, Bartonella Neuroretinitis, Loss of Vision, Flame Shaped Hemorrhages, Branch
Retinal Artery Occlusion with Vision Loss, Cotton Wool Exudates, Parinaud’s Oculoglandular Syndrome,
and Papilledema.

BONES AND MUSCLES: Osteomyelitis, Myositis, Osteolytic Lesions (softening of bone), Myelitis,
Radiculitis, Transverse Myelitis, Arthritis, Chronic Demyelinating Polyneuropathy.

HEART: Endocarditis, Cardiomegaly.
Possible lab findings: The following may show up during standard testing:

Thrombocytopenia, pancytopenia, anemia, elevated serum alkaline phosphatase level, elevated bilirubin, abnormal liver enzymes.
X-ray of the bone may show areas of lysis or poorly-defined areas of cortical destruction with periosteal
reaction. Cardiomegaly may show up on a chest X-Ray.

Biopsies of lymph nodes reveal pathology often indistinguishable from sarcoidosis. Reports of biopsies
strongly suggestive of lymphoma do occur.

Tests occasionally show an enlarged liver with multiple hypodense areas scattered throughout the
parenchyma.

TREATMENT: You MUST consult a knowledgeable physician for information on treatment for
disseminated Bartonella. Some of the medications which have been used in the past have included
Doxycycline (with or without Rifampin), Ciprofloxacin, Erythromycin, Azithromycin,
trimethoprim-sulphamethoxazole, gentamicin, and other macrolide antibiotics.

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posted 09 May 2002 07:17            

this is great information --
can you also post the sources you obtained it from?
I really like to read research/review articles, etc because often they provide links to more and still more info
and also it is useful to have sources to cite when trying to deal with doctors and insurance companies
(not to mention skeptical friends and family!)

thanks
--LK

PS-I don't think there's anything extraneous in your post -- nothing to be edited!

posted 03 March 2003 11:17            

ummm... what are cotton wool exudates?

posted 15 July 2003 20:05               

Tincup,

Execellent! A future table-format as a check-

off list?

In Excel, far left column of Sxs, the rest

of the columns to the right could be the

days of the week, and the person could

record the time of occurence?

posted 15 July 2003 23:35            

You said...

"A future table-format as a check-

off list?

In Excel, far left column of Sxs, the rest

of the columns to the right could be the

days of the week, and the person could

record the time of occurence?"

Sorry.. You don't hardly think I have a clue what any of that computer stuff means.. do ya?

Sorry... I am not computer literate enough to do what you are saying... heck.. I don't even KNOW what you are saying.

But.. it sounds like a good idea!

posted 17 July 2003 12:28            

Sponge, sponge,,
SUX, SUX,
I'm full now, thank you, how refreshing....

TC,
I think you are entitle to mark the 8,000 served and still pouring!!??
UP, UP

posted 17 July 2003 13:06               

Thanks so much.....everything in one neat article!!

Thanks for bringing this to the top.

Any problem with us using this article for education, etc (duck food)?