Rheumatologic Manifestations:

Below are a list of scholarly articles and case reports outlining the ways bartonella infections can cause musculoskeletal injury and pain. The disease process is quite inflammatory. One of it's complicating processes similarly mimic disease of auto-immunity. It causes an 'Undifferentiated Connective Tissue Disorder' (UCTD) with inflammatory arthritic like symptoms and generalized pain. More research is underway to "determine the extent to which Bartonella spp. may colonize collagen and/or bone and if persistent infection and inflammation can contribute to the pathogenesis of hypermobility (EDS) that may include progressive joint pain, tendinosis, and meniscal instability".

Reported rheumatic symptoms include:

• Myalgia (muscle pain) and Myositis (muscle inflammation)

• Migratory Arthropathy (shifting joint pain, mainly medium/larger joints- knee, elbow, wrist, hip, etc)

• Long Bone pain

• Joint Laxity and Hypermobility, EDS III like syndrome

• Generalized body pain

• RA, Lupus, Scleroderma, Fibromyaligia, MS-like symptoms (headache, joint/muscle pain, fatigue, memory problems, numbness and tingling in extremities, weakness, myofascial pain, etc)

• Joint Injuries/Delayed Healing/Tendinitis/Tendinosis/Bursitis

• Osteomyelitis

• Muscle fasciculations or twitching

• Arthritis, Back and Hip Pain

• Neuralgia

The 1st case report is of great significance to me!! It describes a 31 yr old female veterinarian's case and is what prompted my 2nd wave of investigation into Bartonellosis. This report read almost identical to my clinical picture (joint breakdown, degenerative arthritis, muscle pain, progressive joint hypermobility, joint laxity, subluxation, Mild Mast Cell Activation Syndrome, Vit D deficiency, etc).

1. Rheumatological presentation of Bartonella koehlerae and Bartonella henselae bacteremias. A case report, 2018

2. Musculoskeletal Manifestations of Cat Scratch Disease. Clinical Infectious Diseases, 2007

3. Bartonella henselae infection: an uncommon mimicker of autoimmune disease. Case reports in pediatrics, 2013

4. Bartonella henselae, Joint Infection and Degenerative Osteoarthritis. Dr. Mozayeni, 2017

5. Cat‐scratch disease–associated arthropathy. Arthritis & Rheumatism, 2005

6. Bartonella spp. Bacteremia and Rheumatic Symptoms in Patients from Lyme Disease–endemic Region. Emerging Infectious Disease, 2012

How it relates to my clinical picture (2017-present)