Neurologic Manifestations:

[Updates coming soon]

Microglial cells of the Central Nervous System (CNS) are one of many cells that Bartonella has been shown to invade. Microglial cells are the macrophages of the Central Nervous System. These cells help mediate the CNS immune response by clearing cellular debris, and injured/dead neurons. They are constantly moving to survey the CNS and play a vital role in infection and inflammation. As mentioned previously, Bartonella also invades the vascular endothelial tissue causing a Small Vessel Inflammatory Disease. Both can damage the Central and Peripheral Nervous System, leading to some of the most debilitating symptoms seen with Bartonellosis.

In the Journal of Infection and Immunity, The American Society for Microbiology reported that "Bartonella henselae selectively infects microglial cells in the brain. Microglia are derived from bone marrow precursor cells and serve as the resident tissue macrophages of the nervous system. Previous studies have demonstrated that macrophages can become infected with B. henselae (25) and identified numerous bartonella organisms within tissue macrophages from humans infected with cat scratch disease (37). Research into the immune response to B. henselae infection also suggests that macrophages play a role in the pathogenesis of infection. Dissemination via macrophages would provide a means for the organism to enter the CNS, as these cells can pass through the blood-brain barrier. Once the organism is inside the brain, infection of local microglial cells may facilitate the development of persistent infections."

Neurologic Manifestations that have been described include:

1. Transient Aphasia

2. MS-like Disease

3. Meningitis

4. Ice-pick Headaches/Migraines

5. Tinnitus

6. Photophobia

7. Insomnia

8. Visual Disturbances

9. Blurred Vision

10. Depression

11. Psychiatric Illness (anxiety, rage, irritability, confusion, auditory or visual hallucinations, derealization, depersonalization, PANS/PANDAS)

12. Peripheral Migratory Neuropathy (disease of one or more nerves typically causing numbness and weakness)

13. Low Pulse Pressure

14. Loss of Coordination

15. Paresis (weakness)

16. Pain Syndromes

17. Focal Transient Muscle Fascinations (twitching)

18. Isolated Tremors

19. Postural Orthostatic Tachycardia

...to name a few!

Below are some great articles discussing this aspect Bartonellosis.

1. Bartonella sp. Bacteremia in Patients with Neurological and Neurocognitive Dysfunction. Journal of Clinical Microbiology

2. Chronic inflammatory demyelinating polyneuropathy as a complication of cat scratch disease, 2000 (scroll to bottom of 1st page)

3. Neurological and immunological dysfunction in two patients with Bartonella henselae bacteremia. Clinical case reports, 2017

4. Vasculitis, cerebral infarction and persistent Bartonella henselae infection in a child. Parasites & vectors, 2016:

5. Spontaneous onset of complex regional pain syndrome Type I in a woman infected with Bartonella koehlerae. Medical microbiology and immunology, 2013: (You have to scroll down a bit for the article)

6. Bartonella henselae infection in a family experiencing neurological and neurocognitive abnormalities after woodlouse hunter spider bites. Parasites & vectors, 2013

7. Neurological Manifestations of Bartonellosis in Immunocompetent Patients: A Composite of Reports from 2005–2012. Journal of Neuroparasitology, 2012

How it relates to my case presentation (2019 to current)