#Bartonella

[psalm40speakstome]

I have a personal beef with whoever decided that healing took so much paperwork

[yaminahsaini]

🇺🇸Mardi 14 mai 2024: Jour 2 des soins à la clinique.🏥 J’ai été perfusée avec des choses qui permettent d’aider à lutter contre ce que j’ai. Comme la dernière fois, l’un des composant de la poche de perfusion n’a pas été toléré par mes veines alors il a fallut en refaire une en enlevant l’une des substances. Ensuite j’ai continué à enchaîner les thérapies, vu le docteur et re eu des traitements etc…

[flyonthewallmedstudent]

Bartonella henselae

Case Report:

23M veterinary student from home with a cat, presents with a one year history of neck swelling, 1 month of fevers and lethargy. Also he lives in Karachi.

The fevers are a/w chills and rigours that response to paracetamol and have no particular pattern to them.

He doesnt have any arthralgias or arthritis or rash.

They find pretty sizable lymph nodes on exam in the cervical chain and inguinal regions.

He starts developing hypotension and they start him on some vasopressors and meropenem.

The fevers don't respond, and someone decides to start azithromycin, which it does respond to.

He's also worked up for IE given the chronicity of events.

Eventually on biopsy of the lymph node, the lab finds bartonella hensalae.

Microbiology + transmission:

aka cat scratch fever, so this is why history is so important to infectious diseases physicians.

it's actually disease of cats that can spread to their humans via bites and scratches. Or the cat licks a wound etc.

and unfortunately also via arthropod vectors and mossies

after entry into a host, it's main target cells are CD34s, immune cells, and then alters the host immune system

it's interesting special power is that it can predispose hosts to other pathogens in this manner

it's a gram negative rod (pink rods)

Historical trivia

the fun bits

genus of Bartonella is named for a Peruvian scientist (Alberto Barton, also had interest in brucellosis and leishmaniasis --> other tropical diseases taht cause fevers of unclear origin), he isolated the bacteria from patients during an outbreak among railway works in South america. This was 1905.

reminds me of love in the time of cholera, when people still wrote physical letters.

species of bartonella henselae is actually named for Diane Henselae, a researcher from Oklahoma, who collected samples during an outbreak there in the mid 1980s.

rare for someone who discovered a species named for them to be both alive and a woman, and I can't find much about her online.

there are other bartonella species that cause historically significant diseases like trench foot (bartonella quintana, transmitted by lice) and carrion's disease (bartonella bacilliformis, with a high mortality rate). another post for another day.

Clinical features

incubation period: up to 10 days

initial: rash at site of injection or intro of pathogen, from there it travels to local lymph nodes causing lymphadenopathy about 1-3 weeks later

From CDC guidelines who took image from NEJM

Bsymptoms - low grade fevers/malaise/fatigue

epidemio: occurs most often (for a rare disease) in kids < 15

Complications

infection affecting the eye (neuro-retinitis = visual changes, irritation and photophobia), liver, spleen, brain/spine (transverse myelitis, encephalitis etc), bones and heart valves (IE)

Increased risk groups for complications

HIV/AIDs, immunocompromised hosts (i.e. transplants), mortality is an issue in this group, as disseminated disease a possibility

small risk of IE in groups with RFs for develop this (prosthetic valves, damaged valves, unrepaired congential heart disease etc)

Investigations

challenging, no gold standard test as the sens and spec is variable for each individual one, so it's a combination really, of history exam and a variety of confirmatory tests

PCR (variable spec/sens), serology (indirect and often negative in early stages, can also be positive for years post treatment and doesn't differentiate from other bartonella species), cultures are definitive but it can take 21 days for anything to grow (it's fastidious)

histopath of lymph nodes helpful - stains: silver stain or Warthin Starry stain (silver nitrate) which is kind of a reverse starry starry night used for spirochetes like helicobacter.

in IE, it can be culture negative, which can confuse diagnosis

From Wiki

Management

mild disease is self resolving

first line: few days azithromycin or doxycycline can reduce symptoms and is indicated for enlarged lymph nodes to reduce size or unresolving LAD >1 month

in case of eye infection or IE expect longer duration of hterapy, like doxy and rif for 4-6 weeks

will also respond to bactrim, cipro, rif and gent

Prevention from the CDC:

avoid strays, wash hands after petting cats, keep strays from your cat, avoid owning new kittens who are < 1 yr if you are immunocompromised

avoid getting scratched..which is kinda hilarious but can see why

Sources

stat pearls

case report above

wikipaedia

Rare diseases

CDC guidelines

[oliveasaltylife]

Well, it’s finally happening. My parents are withdrawing a portion of my monthly financial support. My husband has been out of work since early October and he finally found a job, but isn’t able to start until January.

We desperately need help to be able to make rent, pay utilities, and get food on the table on top of other monthly bills that can not go unpaid. I have spent the past 2 years begging my parents for the help they explicitly promised me when they found out my FIL gave me COVID in January 2022. I never recovered and still have a whole host of other complex health conditions that was significantly exacerbated. I still don’t have a definitive answer whether or not Long COVID is part of it because it reactivated a latent Bartonella infection that I got who knows how long ago. Not to mention the connective tissue disorder, dysautonomia, MCAS, chiari, and tethered cord I was already dealing with pre-infection, just undiagnosed and not taken seriously. My parents offered to help me financially because I had to stop working. I went back to work after my infection cleared, even though I know I wasn’t fully recovered, and relapsed very hard in May of 2022. That was when the full financial assistance from my parents really began, and they continued to try to convince me they would never turn down helping me.

For the next 6 months my mother berated me and made it known that she resents me because she wasn’t able to get “her pool” installed in the summer of 2022 because she had to help me, her eldest daughter. At one point she made me choose between my health and wellbeing or my sister’s (she is also disabled, but lives at home, and receives SSDI, which I do not qualify for). She ate her words that time. But they’ve been trying to get out of helping me ever since they offered. And now, my parents have taken it upon themselves to lower my financial assistance after my husband lost his job, and without even consulting me. They texted my husband, never made contact with me, and when I called them out on it made excuses that I don’t talk to them often enough. (Huh, imagine that. I don’t really want to contact my abusive parents, but it sure does highlight some of the abuse that’s gone on my entire life). I am not in a position to be able to turn down what they are giving me, though I can not wait until the day I can officially become no contact.

I need help. I’m exhausted from trying to fight for assistance I was promised by my own parents in addition to the extreme exhaustion that comes with living with complex chronic illness. I don’t know what to do at this point. I’m going to leave my Venmo link in hopes that maybe some of you are in a position that allows you to give assistance. If you are not able to, please share this. I don’t have a platform on any of my socials and really do not feel comfortable sharing it on Facebook where I have family members who also choose to ignore pleas for help.

[diariesofabuggygirl]

Hello Again. Long time no see.

You haven't heard from me for a while. I was doing really well. Between the strain on my parents and I's relationship, and the improvement in my health I moved out.

It was great. I was so hopeful, and mostly able to care for myself.

The brand new apartment building hadn't been built correctly. I got hit by mold bad. I've been out of it for almost six months. I'm really sick again. It's better than it was, but, it's a nightmare.

I had finally started getting a lot of the positive effects from my neuro surgeries. That, figuring out my trauma, and medical cannabis changed my life.

Now I'm mostly bedridden again. My cannabis isn't as effective. My tolerance is crazy. And tolerance breaks aren't well tolerated, and don't help much. I am so tired of being uncomfortable, in pain, fatigued, and anxious.

I'm so devastated. Assisted suicide is feeling like an option again, though I plan on giving myself time first. I hate it. I hate I need this outlet again. I hate I'm back here in this place.

I cant stop thinking about what my life will look like when my parents are gone. Our relationship is much improved, thank god. But theyr'e at the point in life that kids are supposed to start taking care of them. And here I am still unable to care for myself, and they are having to burn themselves out for me.

They've worked on nothing but me and my health for 16 years this month.

I have one good friend. My relationship with my sibling is much improved. But I am so lonely. I want a partner so badly. And I don't even feel well enough to spend much time with the people i do have. When my parents pass, which I hope is far from now, my life will be so empty.

I am terrified. I don't know what else to say.

[seaseachronix]

Guys, I’ve been thinking I have Bartonellosis, I have all the symptoms, fever, anxiety, depression, rage, and also blurry vision and vision problems, anyone else think so?

[psalm40speakstome]

@soundlessdragon I deeply appreciate you saw this and thought of me.

[drugcarts]

Trench fever is also called as "five-day fever". Bartonella quintana bacteria is primarily carried by a vector called the body louse.

[psalm40speakstome]

Day after tomorrow I have a phone call with a potential OCD Therapist that I’ve been emailing.

Any thoughts, prayers, good vibes, really anything would be appreciated.

[ephemerabanter]

May is Lyme Disease Awareness Month!

- Most people are undereducated about Lyme, which is so much more than a rash and joint pain (the vast majority of Lyme patients do not recall a rash or never had one!)

- Standard testing for Lyme produces false negatives more than half the time.  

- Many people diagnosed with Chronic Fatigue Syndrome, Fibromyalgia, MS, psychiatric conditions, and a host of other afflictions, actually have Lyme.

- The bacteria that causes Lyme often persists after the typical course of antibiotics prescribed, causing a whole host of symptoms across multiple systems in a person's body.  These symptoms can range from mild to debilitating.  

- Lyme travels with friends!  Most people contract more than "just" Borrelia Burgdorferi from a tick bite.  Other common tickborne diseases that Lyme patients typically struggle with include Bartonella, Babesia, and many more.

Learn more about Lyme at https://projectlyme.org/lyme-basics/

Do you suspect you might have Lyme?  Here's a free test that will give you more insight into whether Lyme may be causing your symptoms:  https://doyouhavelyme.com/online-test-form/

[yaminahsaini]

J’avais re eu une consultation avec le docteur qui m’avait prescrit la prise de sang pour re contrôler Bartonella etc…Je vais donc vous résumer le rdv et les résultats. Tout d’abord mes globules blanc affichent quasi à chaque fois qu’ils sont élevés depuis toujours.. Ça prouve juste que mon corps lutte constamment contre des infections. Ensuite j’ai des anticorps antinucléaires ultra élevés (encore plus que la dernière fois). Le docteur m’a dit que ça montre une maladie auto-immune (du coup les anticorps m’attaquent moi au lieu de me défendre). Et elle m’a dit qu’on ne pouvait rien faire face à cela mise à part supprimer totalement le lait de vache et le gluten. D’ailleurs durant le rdv on a recontacté la diététicienne pour voir où en est le fait d’avoir de nouvelles poches de nutritions, et ça avance enfin! Je vous expliquerais dans une prochaine publication. Pour continuer avec les résultats, j’ai plusieurs carences. Elle m’a donc prescrit : du zinc, du fer et de la vitamine D à prendre tous les jours. Je suis également en manque de protéines mais ça j’en aurais plus avec les nouvelles poches de nutrition. Arrive désormais le plus important ! Les résultats de la Bartonella! Le docteur était tout autant surprise que moi de voir que je suis négatif ! Alors que j’étais extrêmement positif à la Bartonellose (aux IgG et IgM), et là plus rien! Au début le docteur m’avait dit que ça ne voulait rien dire car ça peut être un faux négatif étant donné que lorsque le système immunitaire est trop faible, la bactérie peut se cacher (surtout bartonella qui s’adapte très bien). Et surtout, même en étant négatif, je dois au moins avoir les anticorps qui apparaissent! Mais là aucune trace que mon corps a lutté contre ça. Je lui ai ensuite rappelé mon traitement des USA qui se base sur phagothérapie (elle avait oubliée), et m’a dit que c’était vraiment très bien que j’ai pu avoir l’opportunité de bénéficier de ça! Et que si j’en avais les moyens, le continuer ne serait que bénéfique. Car pour rappel le traitement des États-Unis est justement fait pour tout éradiquer, d’où le fait que je n’ai même plus les anticorps. Après malheureusement il existe énormément d’espèces de Bartonella. Moi on m’a seulement contrôlé la plus basique : Bartonella henselae. Hors aux États-Unis ont m’en a trouvé 4 espèces. Est-ce que tout a bien été éradiqué ? Je ne sais pas car pour être sûre il faudrait faire des tests plus poussé, qui ne sont pas pris en charge et très coûteux.. En tout cas on part du principe que je n’ai plus la Bartonella et c’est déjà très prometteur comme avancé !! Ce qu’il faudrait c’est éliminé les infections une part une. Mais même ainsi le corps garde énormément de dégâts, de toxine. Le docteur me disait que face à cela il faut faire du sauna, de l’oxygénothérapie hyperbare.. bref tout ce que je faisais aux États-Unis car c’est extrêmement bénéfique pour rebooster son corps! Heureusement que je peux au moins faire l’oxygénothérapie hyperbare gratuitement en France grâce à de superbes personnes!! Après encore une fois tout cela est trop coûteux… Malheureusement pour s’en sortir avec ce genre de maladie, il faut les moyens et surtout s’y connaître bien. Nous avons reparlé de mes réactions aux antibiotiques, évidemment elle a tout de suite compris mon problème et m’a dit que tous mes symptômes s’amplifient car je suis infesté de bactéries jusqu’au bout de ma tête et que le moindre antibiotique est une aggression pour eux.. Le docteur m’a donc re prescrit un antibiotique juste comme test au cas où je tolère cette fois-ci. Car ça ne pourrait être que bénéfique d’éliminer ce qui est néfaste. J’ai vraiment peur de le prendre car les effets sont intolérables.. Bon, le Dr m’a dit de ne surtout pas tout commencé en même temps (fer, zinc, nouvelle nutrition etc..) comme ça si j’ai des effets secondaires, on saurait de quoi ça vient. D’ailleurs on a refais le point sur tous mes symptômes, elle évoquait certains symptômes que j’ai au quotidien dont je ne savais même pas que c’était lyme ! Ça faisait vraiment du bien de se sentir comprise!

[femmeboyhooters]

Anyone with chronic lyme disease have the rash come in when treating?

[crisscrosscutout]

Fibionacci’s cat

(Longtime no see, this is Bart)

[cavaliersecondary]

been noticing my stretch marks have been white for a while which is very reassuring :)

[THIS POST IS ABOUT BEING BEING DISEASED WITH A BLOOD INFECTION NOT ABOUT WEIGHT]

[literaryvein-reblogs]

Writing Notes: Bites & Stings

References (Dog Bites; Cat; Human; Spider; Bee & Wasp; Snake; Jellyfish)

Bites and stings - puncture injuries inflicted by an animal that penetrate the skin.

DOGS

A typical dog bite results in a laceration, tear, puncture, or crush injury.

Bites from large, powerful dogs may cause fractures and dangerous internal injuries. Dogs trained to attack may bite repeatedly during a single episode.

Infected bites usually cause pain, cellulitis (inflammation of the connective tissues), and a pus-filled discharge at the wound site within 8–24 hours.

Many infections are confined to the wound site, but some of the microorganisms in the mouths of dogs can cause systemic and possibly life-threatening infections.

Rabies is rare among pet dogs in the United States, most of which have been vaccinated against the disease. Tetanus is also rare but can be transmitted by a dog bite if the victim is not immunized.

CATS

The mouths of cats and dogs contain many of the same microorganisms.

Cat scratches and bites are also capable of transmitting the Bartonella henselae bacterium, which can lead to cat-scratch disease, an unpleasant but usually not life-threatening illness.

Cat bites are mostly found on the arms and hands.

Sharp cat teeth typically leave behind a deep puncture wound that can reach muscles, tendons, and bones, which are vulnerable to infection because of their comparatively poor blood supply.

This is why cat bites are much more likely to become infected than dog bites.

Also, people are less inclined to view cat bites as dangerous and requiring immediate attention; the risk that infection has set in by the time a medical professional is consulted is thus greater.

HUMANS

Humans bites result from fights, sexual activity, medical and dental treatment, and seizures. Bites raise the possibility of spousal or child abuse.

Children often bite other children, but those bites are hardly ever severe.

Human bites are capable of transmitting a wide range of dangerous diseases, including hepatitis B, syphilis, and tuberculosis.

Human bites fall into two categories:

Occlusional (true) bites present a lower risk of infection.

Clenched-fist injuries, which are very infectious and can permanently damage the hand, usually result from a fist hitting teeth during a fight.

People often wait before seeking treatment for a clenched-fist injury, with the result that about half of such injuries are infected by the time they are seen by a medical professional.

SPIDERS

As a rule, people rarely see a black widow bite, nor do they feel the bite as it occurs. The first (and possibly only) evidence that a person has been bitten may be a mild swelling of the injured area and two red puncture marks.

Within a short time, some victims begin to experience severe muscle cramps and rigidity of the abdominal muscles. Other possible symptoms include excessive sweating, nausea, vomiting, headaches, and vertigo, as well as breathing, vision, and speech problems.

A brown spider’s bite can lead to necrotic arachnidism, in which the tissue in an area of up to several inches around the bite becomes necrotic (dies), producing an open sore that can take months or years to disappear.

In most cases, the bite simply produces a hard, painful, itchy, and discolored area that heals without treatment in 2–3 days.

The bite may be accompanied by a fever, chills, edema (an accumulation of excess tissue fluid), nausea and vomiting, dizziness, muscle and joint pain, and a rash.

BEES & WASPS

The familiar symptoms of bee and wasp stings include pain, redness, swelling, and itchiness in the area of the sting.

Multiple stings can have much more severe consequences, such as anaphylaxis, a life-threatening allergic reaction that occurs in hypersensitive persons.

SNAKES

Venomous pit viper bites usually begin to swell within 10 minutes and sometimes are painful.

Other symptoms include skin blisters and discoloration, weakness, sweating, nausea, faintness, dizziness, bruising, and tender lymph nodes.

Severe poisoning can lead to tingling in the scalp, fingers, and toes; muscle contractions; an elevated heart rate; rapid breathing; large drops in body temperature and blood pressure; vomiting of blood; and coma.

Many pit viper and coral snake bites (20–60%) fail to poison (envenomate) their victim, or introduce only a small amount of venom into the victim’s body.

The wounds, however, can still become infected by the harmful microorganisms that snakes carry in their mouths.

Coral snake bites are painful but may be hard to see.

One to seven hours after the bite, a bitten person begins to experience the effects of the venom, which include tingling at the wound site, weakness, nausea, vomiting, excessive salivation, and irrational behavior.

Major nerves of the body can become paralyzed for 6–14 days, causing double vision, difficulty swallowing and speaking, respiratory failure, and other problems.

Six to eight weeks may be needed before normal muscular strength is regained.

JELLYFISH

Jellyfish venom is delivered by barbs called nematocysts, which are located on the creature’s tentacles and penetrate the skin of people who brush up against them. Instantly, painful and itchy red lesions usually result.

The pain can continue up to 48 hours.

Severe cases may lead to skin necrosis, muscle spasms and cramps, vomiting, nausea, diarrhea, headaches, excessive sweating, and other symptoms.

In rare instances, cardiorespiratory failure may occur.

Source ⚜ More: Writing Notes & References More: Writing Realistic Injuries ⚜ On Anatomy ⚜ Poison ⚜ Fight Scenes Part 1 2