Bartonella - Psychiatric Symptoms & Neurological Symptoms

[Guest guest]

Bartonella

Psychiatric Symptoms & Neurological Symptoms

_http://www.personalconsult.com/articles/bartonellasymptoms.html_

(http://www.personalconsult.com/articles/bartonellasymptoms.html)

James L. Schaller; MD, MAR, DABPN, DAAPM, CMI, CMR, PA

 

If you ask most psychiatrists or neurologist about Bartonella, I doubt if

many would think it is a common infection in the USA. Even elite physicians who

understand that Bartonella (**cat scratch fever**) is not rare, would not

call in the CDC or report it routinely to anyone. It is carried in many

organisms including tiny poppy-seed sized ticks and a mere flea, and is common

in

many states in the USA. Of course, do not expect this to be discussed much

since progressive clinical physicians are often those with no time or a desire

to

fight with government agencies.

 

So why care about Bartonella?

 

First, it routinely causes psychiatric symptoms that fail typical

treatments. Antidepressants offer no full cures. Anti-anxiety agents might just

help

50%. Individuals with Bartonella can feel depressed, irritable, hostile,

aggressive and can have rage attacks and panic attacks. Hallucinations, strokes

and seizures are possible but not routine.

 

If you find that good and sincere physicians are saying, **We do not know

why you have _________.** Then you should consider being tested for Bartonella.

Of course, like most infections carried by ticks, the quality of the lab

matters a great deal. Have the testing done at a facility which both

specializes

in tick disease and which has solid licensing, e.g., Medicare approved, NY

State approved and California state approved lab. Only one lab appears to meet

these criteria--IGeneX labs at (800 832 3200).

 

Below are some examples of extreme disease from Bartonella. If it can hurt

you severely as is seen in the abstracts below, it can hurt you in a more

subtle manner, with psychiatric symptoms.

 

 

 

--

 

J Clin Psychiatry. 1995 Apr;56(4):161-6.

 

Bacillary angiomatosis: a treatable cause of acute psychiatric symptoms in

human immunodeficiency virus infection.

 

Baker J, Ruiz-Rodriguez R, Whitfeld M, Heon V, Berger TG.

 

Department of Psychiatry, San Francisco General Hospital, CA 94110, USA.

 

BACKGROUND: Bacillary angiomatosis is a systemic infection that has been

most commonly reported in the setting of immunosuppression, especially human

immunodeficiency virus (HIV) disease.

METHOD: We report two patients who had bacillary angiomatosis who presented

with psychiatric symptoms.

RESULTS: The first patient presented with marked exacerbation of previous

depressive disease. The second patient presented with new psychotic symptoms.

In both cases psychiatric symptoms did not resolve until antibiotic treatment

was given. CONCLUSION: Our report expands the clinical spectrum of bacillary

angiomatosis and identifies a new cause of treatable psychiatric disease in

HIV-infected persons.

 

Publication Types:

 

Case Reports

PMID: 7713855 [PubMed - indexed for MEDLINE]

 

 

 

--

 

Presse Med. 2005 Feb 26;34(4):297-8.

 

[bartonella hensalae encephalopathy]

 

[Article in French]

 

Angibaud G, Balague JP, Lafontan JF.

 

Service de neurologie, Clinique du Pont de Chaume, 82 017 Montauban, France.

 

INTRODUCTION: Bartonella hensalae is a poorly known cause of encephalopathy

in young subjects.

OBSERVATION: A 17 year-old adolescent was admitted in a state of emergency

because of frequent convulsive seizures and inter-critical drowsiness. The

diagnosis of encephalopathy was made on the association of these clinical signs

and electro-encephalographic abnormalities. The presence of a cat in his

home, a right axillary lymph node that had appeared in a context of fever, and

positive serological kinetics related this encephalopathy to a bartonellosis.

The course was good.

DISCUSSION: Diagnosis of a Bartonella hensalae encephalopathy is based on a

range of anamnesic, clinical and microbiological arguments. The potential

interest of antibiotic therapy and its modalities remains to be established.

 

Publication Types:

 

Case Reports

PMID: 15798550 [PubMed - indexed for MEDLINE]

 

 

 

--

 

Braz J Infect Dis. 2004 Jun;8(3):263-6. Epub 2004 Sep 29.

 

Acute hemiplegia associated with cat-scratch disease.

 

Rocha JL, Pellegrino LN, Riella LV, Martins LT.

 

Department of Infectious Disease, Nossa Senhora das Gracas Hospital,

Curitiba, PR, Brazil. _jaimeluis_ (jaimeluis)

 

Cat scratch disease (CSD) is an infectious illness caused by a Gram-negative

rod named Bartonella henselae. Typical CSD is characterized by a small skin

lesion at the site of a scratch or a bite, followed by regional

lymphadenopathy, one to two weeks later. Atypical forms may present as ocular

manifestations, neurological manifestations, hepatosplenic involvement and

vertebral

osteomyelitis. Among neurological complications, encephalopathy is by far the

most common. Other neurological manifestations are very rare. We report a case

of an 11-year-old boy, with a posterior cervical lymphadenopathy and fever.

Cat scratch disease was diagnosed and treated after a positive

**Whartin-Starry** stain on lymph node biopsy. Two weeks after treatment, the

patient was

readmitted presenting an acute episode of left hemiplegia. A brain MRI

demonstrated a right subcortical fronto-parietal lesion with no contrast

enhancement.

Complete recovery was observed after corticosteroid treatment.

 

Publication Types:

 

Case Reports

PMID: 15476060 [PubMed - indexed for MEDLINE]

 

 

 

--

 

Seizure. 2004 Apr;13(3):191-5.

 

Epilepsia partialis continua in cat scratch disease.

 

Puligheddu M, Giagheddu A, Genugu F, Giagheddu M, Marrosu F.

 

Department of Cardiovascular and Neurological Sciences, University of

Cagliari, SS 554, Bivio Sestu, 09042 Monserrato, Cagliari, Italy.

 

Cat scratch disease (CSD) is a world-wide, diffuse, non-epidemic infection

caused by the Gram-negative bacillus Bartonella henselae. The occurrence of

encephalopathy represents an infrequent and atypical complication, whose

manifestations include ischemic strokes, transverse myelitis and epileptic

seizures. Status epilepticus has been described as the most frequent emergency

in CSD

encephalopathy. In this report, we describe a case of CSD complicated by an

epilepsia partialis continua (EPC) manifested as rhythmic movements of the

flexor muscles of the left hand. Although CSD is a benign, self-limited disease

and a complete neurological recovery usually occurs, in the present case the

EPC resulted in a partial epilepsy. Magnetic resonance imaging (MRI), single

photon emission computed tomography (SPECT) and back-averaged EEG data

recorded during myoclonic activity document this CSD complication.

 

Publication Types:

 

Case Reports

PMID: 15010059 [PubMed - indexed for MEDLINE]

 

 

 

--

 

J Neuroimaging. 2003 Jan;13(1):79-82.

 

Diffusion-weighted magnetic resonance imaging abnormalities in Bartonella

encephalopathy.

 

Singhal AB, Newstein MC, Budzik R, Cha JH, Rordorf G, Buonanno FS, Panzara

MA.

 

Department of Neurology, Massachusetts General Hospital, Biogen, Inc. (MAP),

Boston, USA. _asinghal_ (asinghal)

 

The authors describe 2 patients with new-onset, refractory status

epilepticus and serological evidence for Bartonella infection. Brain magnetic

resonance

imaging (MRI) in patient 1 showed transient diffusion abnormalities in the

posterior (pulvinar) thalami. In patient 2, brain MRI showed several enhancing

cortical lesions, of which one lesion was bright on diffusion-weighted

imaging (DWI). In patients with unexplained, refractory seizures, the presence

of

DWI abnormalities warrants a search for unusual infectious or inflammatory

disorders, like Bartonella encephalitis.

 

Publication Types:

 

Case Reports

PMID: 12593136 [PubMed - indexed for MEDLINE]

 

 

 

--

 

Pediatrics. 2002 Aug;110(2 Pt 1):e21.

 

Acute disseminated encephalomyelitis in children.

 

Murthy SN, Faden HS, Cohen ME, Bakshi R.

 

Department of Neurology, State University of New York at Buffalo, School of

Medicine and Biomedical Sciences, Buffalo, New York, USA.

 

OBJECTIVE: To describe the epidemiologic, clinical, neuroimaging, and

laboratory features; treatment; and outcome in a cohort of children with acute

disseminated encephalomyelitis (ADEM).

METHODS: A 6-year retrospective chart review of children with the diagnosis

of ADEM was conducted.

RESULTS: Eighteen cases were identified. Sixteen patients (88%) presented in

either winter or spring. Thirteen children (72%) had a recent upper

respiratory tract illness. Patients presented most often with motor deficits

(77%)

and secondly with altered consciousness (45%). Spinal fluid abnormalities

occurred in 70%. Despite rigorous microbiologic testing, a definite

microbiologic

diagnosis was established only in 1 child with Epstein-Barr virus disease and

probable or possible diagnoses in 3 children with Bartonella henselae,

Mycoplasma pneumoniae, or rotavirus disease. Brain magnetic resonance imaging

identified lesions in the cerebral cortex in 80%, in subcortical white matter

in

93%, in periventricular white matter in 60%, in deep gray matter in 47%, and

in brainstem in 47% of patients. Eleven patients (61%) were treated with

corticosteroids, and 2 were treated with intravenous immunoglobulins. All

patients survived. Three patients (17%) had long-term neurologic sequelae.

CONCLUSIONS: Epidemiologic evidence from this study suggests an infectious

cause for ADEM. The agent is most likely a difficult-to-diagnose winter/spring

respiratory virus. Magnetic resonance imaging was the neuroimaging study of

choice for establishing the diagnosis and for following the course of the

disease. Prognosis for survival and outcome was excellent. Recurrent episodes

of

ADEM must be differentiated from multiple sclerosis.

 

PMID: 12165620 [PubMed - indexed for MEDLINE]

 

 

 

--

 

J Forensic Sci. 2002 May;47(3):640-4.

 

Fatal meningitis and encephalitis due to Bartonella henselae bacteria.

 

Gerber JE, Johnson JE, Scott MA, Madhusudhan KT.

 

Forensic Medical, Nashville, TN 37216, USA.

 

Bacterial infection due to Bartonella henselae commonly develops in children

and young adults following cat/dog contacts and/or cat/dog scratches.

Regional lymphadenopathy is its most common clinical expression. However,

encephalitis and Parinaud's syndrome (oculoglandular syndrome) have also been

reported

as has systemic illness. A review of the international literature in all

languages revealed no fatal complications in immunocompetent hosts. A

four-year-old white child with no underlying illness began to have seizure-like

activity. She was taken to a local hospital and subsequently transferred to a

medical center. The child was treated aggressively for seizures and fever of

unknown origin. However, her condition rapidly declined and she died without a

specific diagnosis. At autopsy there was marked cerebral edema with no gross

evidence of acute meningitis. Microscopic exams revealed multiple granulomatous

lesions as well as a meningitis and encephalitis. A variety of cultures and

stains were negative for acid fast and fungal organisms. Warthin-Starry stains

of involved tissue including brain and liver revealed pleomorphic rod shaped

bacilli consistent with Barronella henselae. Analysis of brain tissue with

polymerase chain reaction (PCR) and Southern blot for the deoxyribonucleic acid

(DNA) was definitive for DNA of Bartonella henselae bacteria.

 

Publication Types:

 

Case Reports

PMID: 12051353 [PubMed - indexed for MEDLINE]

 

 

 

--

 

Kansenshogaku Zasshi. 2002 Feb;76(2):113-7.

 

[A case of cat scratch disease with encephalopathy]

 

[Article in Japanese]

 

Touyama M, Uezu K, Nakamoto A, Shinzato T, Higa F, Tateyama M, Saito A,

Nakamura M, Tsuneoka H, Tsukahara M.

 

First Department of Internal Medicine, Faculty of Medicine, University of

the Ryukyus.

 

We report an atypical case of cat scratch disease (CSD), accompanied with

encephalopathy that is a rare complication of CSD. A 17-year old man consulted

a doctor for his right axillary lymphadenopathy. [big lymph nodes] The

history of his contact with cats and the sign of lymphnode swelling and fever

suggested a suspect of cat scratch disease. Administration of ampicillin

improved

his clinical symptoms, but a few days later he suddenly fell into coma after

an episode of convulsion. The CT scan of the brain and laboratory tests

showed no significant findings except the slightly elevated cell counts and

concentration of protein in his cerebrospinal fluid. He was referred to our

hospital on the next day for further examinations and treatments for his coma

of

unknown cause. The physical examination on admission revealed slight neck

stiffening and hypertonicity of his right lower limb, but radiological and

laboratory tests showed no significant findings. He gradually recovered from

his coma

without apparent sequelae in three weeks. Indirect fluorescence antibody

titers for CSD in his serum showed a significant elevation to 1:160 of IgM and

1:512 of IgG, and his clinical features were compatible to these of CSD with

complications of the central nervous system.

 

Publication Types:

 

Case Reports

PMID: 11904996 [PubMed - indexed for MEDLINE]

 

 

 

--

 

Infect Immun. 2001 Jan;69(1):564-9.

 

Infection of fetal feline brain cells in culture with Bartonella henselae.

 

Munana KR, Vitek SM, Hegarty BC, Kordick DL, Breitschwerdt EB.

 

Department of Clinical Sciences, College of Veterinary Medicine, North

Carolina State University, Raleigh, North Carolina 27606, USA.

_Karen_Munana_ (Karen_Munana)

 

Bartonella henselae is known to cause central nervous system (CNS) disease

in humans, and neurological signs have been observed in experimentally

infected cats. However, the pathogenesis of CNS disease remains unclear. This

study

was undertaken to determine whether B. henselae infects feline fetal brain

cells in vitro. Microglial-cell- and astrocyte-enriched cultures were

inoculated with B. henselae. Gimenez staining identified bacterial organisms

within

microglial cells by day 7 postinoculation. The viability of the intracellular

bacteria was demonstrated by incubating cultures with gentamicin and plating

cell lysate on agar. Electron microscopy identified intracellular organisms

with characteristic Bartonella morphology but identified no ultrastructural

abnormalities within infected microglial cells. No evidence of infection was

seen in Bartonella-inoculated astrocyte cultures. These findings suggest a role

for microglia in the pathogenesis of B. henselae-associated neurological

disease.

 

PMID: 11119554 [PubMed - indexed for MEDLINE]

 

(http://www.papercut.biz/emailStripper.htm)