• Dr. Nicole Vumbaco | DVM

Part 2: What is Bartonellosis? What's my treatment plan?

Updated: Nov 15

What is Bartonellosis?

I am going to try to avoid getting “science-y” or too medical here. Although the science is incredible, I do not want to alienate anyone who is non-medical. The two links in Part 1 are easy reads and very succinct. In the 'Bartonellosis Education' section of this blog you will find many useful subjects discussed in greater detail.

In summary, Bartonella is a bacteria that lives within the cells of it’s host. It is one of the most fascinating and yet, terrifying pathogens I have learned about, to date. It is extremely stealth, evades immune detection, infects CD34+ progenitor cells of the bone marrow, endothelial tissue (the thin layer of cells that line the interior surface of blood and lymphatic vessels), and microglial cells (a macrophage of the nervous system), to name a few. It can infect multiple species (like dogs, cats, humans, rodents, marine mammals), and is constantly evolving and adapting to each host.

Classified as zoonotic bacterial infection, Bartonellosis causes a Small Vessel Inflammatory Disease and Connective Tissue Disorder that can affect multiple organ systems; it has a propensity for endothelial lining and collagen, respectively.

Clinical presentations can range from asymptomatic to mild to severely debilitating. It depends on the health of your immune system. Some people are even asymptomatic, and if your immune system is strong, the infection can be contained. This is one of the reasons I believe 2019 became my most debilitating year. There was an overabundance of system disruptors and multiple rounds of steroids (likely further weakening my immune system). Symptoms can include muscle and joint pain, long bone pain, nerve pain, weakness, tremors, muscle twitching, skin rash or striations, headache/migraines, hypermobility, and depression to name a few. Symptoms can be constant but more commonly are described as cyclic and migratory (with variations in severity). This variability further convolutes it's distinction to doctors and can make early diagnosis extremely difficult.

Being an intracellular bacteria, Bartonella will commonly infect sites locally but can also be carried to areas distant to the initial point of inoculation. Bartonella is capable of causing a low grade inflammatory state, which it thrives in. One of Bartonella's defining characteristics is it's ability to simultaneously release new bacteria into the blood stream every 4-8 days. There is a coordinated cycle to the chronic bacteremia (transient bacteria in blood stream) until it invades new cells, which further assists in minimizing immune detection. Think about that, a simultaneous release from all infected areas!! (This is why it is recommended to have blood samples attained every other day for a week - coined "triple draw"- to capture this release). Mine seems to be every 6-8 days which is followed by a low-grade fever, severe increase in my symptoms and extreme exhaustion.

Research has shown strong correlation between Bartonellosis' potential to mimic and/or trigger autoimmune disease, something I am teetering on the edge of. There is also potential for complex neurologic symptoms affecting the Central and/or Peripheral Nervous System (like Postural Orthostatic Tachycardia Syndrome, peripheral neuropathy, weakness, radicular shooting pains, changes in mental health - all of which are present within my symptomology as well). National Jewish Health is working with my other doctors and closely monitoring this. Secondary to chronic illness, there are multiple downstream effects that can and do occur. These further compromise a host's resiliency (your response). I have developed hormonal dysregulation and multiple vitamin/mineral deficiencies. More recently my pulmonary function tests were sub-optimal and echocardiogram (heart scan) showed valve regurgitation (mitral, tricuspid and pulmonic valves) with an "incidental" decrease in right ventricular systolic function (meaning overall heart function still looks good). I’ve developed progressing issues with peripheral circulation and an intermittent low white blood cell count (leukopenia and neutropenia).