Bartonella spp. Bacteremia and Rheumatic Symptoms in Patients from Lyme Disease–endemic Region

• Main Authors: Ricardo G. Maggi, B. Robert Mozayeni, Elizabeth L. Pultorak, Barbara C. Hegarty, Julie M. Bradley, Maria Correa, Edward B. Breitschwerdt
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2012-05-01
• Series: Emerging Infectious Diseases
• Subjects: Bartonella; blood; arthritis; myalgia; PCR; DNA sequencing
• Online Access: https://wwwnc.cdc.gov/eid/article/18/5/11-1366_article

Bartonella spp. infection has been reported in association with an expanding spectrum of symptoms and lesions. Among 296 patients examined by a rheumatologist, prevalence of antibodies against Bartonella henselae, B. koehlerae, or B. vinsonii subsp. berkhoffii (185 [62%]) and Bartonella spp. bacteremia (122 [41.1%]) was high. Conditions diagnosed before referral included Lyme disease (46.6%), arthralgia/arthritis (20.6%), chronic fatigue (19.6%), and fibromyalgia (6.1%). B. henselae bacteremia was significantly associated with prior referral to a neurologist, most often for blurred vision, subcortical neurologic deficits, or numbness in the extremities, whereas B. koehlerae bacteremia was associated with examination by an infectious disease physician. This cross-sectional study cannot establish a causal link between Bartonella spp. infection and the high frequency of neurologic symptoms, myalgia, joint pain, or progressive arthropathy in this population; however, the contribution of Bartonella spp. infection, if any, to these symptoms should be systematically investigated.