In their article, “Bartonella- and Borrelia-Related Disease Presenting as a Neurological Condition Revealing the Need for Better Diagnostics,” Ericson and colleagues describe the case of a 61-year-old female, who experienced a painful bite while hiking in Minnesota.¹
It was diagnosed as a spider bite because of the two large bite marks present and the painful sensation. One day after the bite, a large blue ring appeared around the bite and the woman developed muscle aches and pains.
The woman was treated with doxycycline for two weeks, which decreased but did not resolve the arthritic pain.
Five months later, her symptoms progressed to include blurry vision, lack of balance, muscle pain, night sweats and insomnia.
At this point, testing for Lyme disease and Bartonella were negative.
After expressing continued concern about having Lyme disease, she was referred to an infectious disease physician, who stated that he “did not believe in persistent Lyme disease.” She was then referred to a neurologist for an MRI.
“At this time, her blood was used in a research study aimed at developing new PCR diagnostic techniques for Bartonella infections,” the authors state.
This new PCR test confirmed the presence of both Bartonella vinsonii and Bartonella henselae.
One year after infection, the patient visited an integrative medicine physician who prescribed clarithromycin and rifampin based on symptoms consistent with a Bartonella infection.
However, her symptoms continued and she was referred to a physical therapist, who prescribed a wheeled walker. Her primary care physician attributed her symptoms to possible ALS or MS.
“She reported to multiple physicians that her hips sounded like popcorn whenever she walked or climbed stairs.”
Hip x-rays revealed a loss of cartilage. She had bilateral hip degeneration, which would require hip replacements.
Prior to surgery, the woman underwent another round of tests for Bartonella. And again, test results confirmed for a second time the presence of Bartonella.
However, in addition, testing revealed “a spirochete-like organism” in a buffy coat smear sample.
“Given her symptomology and the known possibility of co-infections in Lyme disease, the spirochete was suspicious for Borrelia burgdorferi.”
Testing for Lyme disease was positive.
Once the woman began treatment for Lyme disease, her condition improved.
However, “Despite the intermittent use of antibiotics for five years, the patient remains positive for Bartonella henselae and Borrelia burgdorferi.”
If she ceases taking antibiotics, her symptoms recur within 3 months.
Authors Conclude:
- “This case report illustrates the inadequacy of conventional tests in diagnosing Bartonella spp. infections, and the potential promise of enhanced techniques.”
- Serology and other antibody-based tests are usually used for Bartonella and Borrelia detection. However, this patient never tested positive through serology but was positive by FISH and PCR testing.
- “The limitations of serology for detecting an active infection need to be more clearly understood by the medical community.”
References:
- Ericson ME, Mozayeni BR, Radovsky L, Bemis LT. Bartonella- and Borrelia-Related Disease Presenting as a Neurological Condition Revealing the Need for Better Diagnostics. Microorganisms. 2024; 12(1):209. https://doi.org/10.3390/microorganisms12010209
Leave a Reply