Bartonella spp. Bacteremia and rheumatic symptoms in patients from lyme disease-endemic region

Published Date
Journal
Emerging Infectious Diseases
Citation
https://wwwnc.cdc.gov/eid/article/18/5/11-1366_article
DOI
10.3201/eid1805.111366
Authors
Maggi RG
Mozayeni BR
Pultorak EL
Hegarty BC
Bradley JM
Correa M
Breitschwerdt EB
Abstract

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.