What is Bartonella?
Bartonella bacteria are gram-negative, meaning they have a double cell wall that acts as a protective capsule. This capsule prevents the immune system's white blood cells from ingesting the bacteria. They are slow-growing, come in different shapes, and are very difficult to isolate in the lab.
Bartonella is typically spread by biting insects (fleas, ticks, mosquitoes, sandflies, lice, chiggers, biting flies, scabies, mites, and even louse-eating spiders), but it can also be transmitted by contaminated bites (of animals), scratches (cat scratch), and ingestion.
Most infections result from a bite or scratch from an infected animal or insect vector.
Bartonella can live inside cells and in isolated locations in the body, protected from the immune system and antibiotics.
The two most well-known species of Bartonella are Bartonella henselae, which causes cat-scratch disease, and Bartonella bacilliformis, which causes Carrión's disease. However, there are over 30 known species of Bartonella, several of which have been associated with human diseases, including Bartonella quintana, which causes trench fever.
These microorganisms can invade various cells in the body, such as red blood cells and endothelial cells, leading to widespread symptoms and challenging diagnosis and treatment.
Despite its potential severity, Bartonella infection or Bartonellosis often remains underdiagnosed due to its stealthy nature and diverse clinical manifestations.
Diagnosis of Bartonella
Diagnosing Bartonella infection can be challenging due to the bacteria's ability to evade the immune system and the broad range of symptoms it can cause. Currently, there is no single definitive test for Bartonella infection.
As a result, it is crucial for individuals experiencing symptoms of Bartonella to seek evaluation by a doctor familiar with the disease, such as Dr. Sponaugle, who has treated thousands of patients suffering from Bartonella.
Diagnosis of Bartonella is often based on clinical history and symptoms alone, although many doctors will seek laboratory testing for confirmation. Serological testing is most readily available and includes the detection of IgG and IgM antibodies. However, false negatives do occur. More advanced testing can include PCR, IFA, or FISH testing.

Symptoms of Bartonella Infection
Bartonella infection's symptoms can vary widely and can present in either an acute or chronic form, making diagnosis difficult. In those with a robust immune system, a Bartonella infection may not cause any symptoms and can even be cleared by the body.
However, if there is immune dysfunction, as is often the case in those with Lyme disease, the infection can become low-grade and take on a chronic form with vague symptoms.
Symptoms can range from mild to severe and affect multiple systems within the body. Common symptoms include fever, fatigue, headaches, and swollen lymph nodes. Individuals may also experience neurological symptoms such as memory loss, anxiety, and mood changes.
Common symptoms of Bartonella infection include:
- Rash, bump, or blister at or near the site of infection
- Fever (typically less than 102º F)
- Swollen lymph nodes near the point of infection, often very large, painful, and filled with pus
- Headache
- Fatigue
- Joint pain
- Decreased appetite
In more severe cases, symptoms can include:
- Red, linear, non-painful skin lesions known as Bart Tracks; often misdiagnosed as stretch marks.
- Rashes or pustules
- Swollen lymph nodes, more generalized and often milder than in acute disease
- Headache
- Fatigue
- Joint pain, bone pain, or pain in tendons and ligaments
- Pain in the soles of the feet, often misdiagnosed as heel spurs or plantar fasciitis
- Anxiety, depression, rage, and other changes in mood
- Neuropsychiatric symptoms such as schizophrenia, mania, panic disorder, and others
- Tingling, numbness, crawling sensation, or buzzing
- Freezing or burning sensation
The Bartonella Rash: A Key Diagnostic Marker
The Bartonella rash, often characterized by distinctive red or purple stretch mark-like patterns on the skin, is a vital diagnostic marker of Bartonella infection.
While not painful or itchy, this rash presents an essential visual indication of the disease. Given its unique appearance, it can direct physicians towards considering Bartonella infection as a differential diagnosis, particularly in patients with possible vector exposure.
Integrative Treatment Options for Bartonella Infection
The management of Bartonella infection can be complex and requires a multifaceted approach due to the systemic involvement of the disease. The mainstay of treatment is antibiotics, usually a combination to cover various stages of the bacteria's life cycle and its intracellular nature.
However, due to potential issues with antibiotic resistance and the side effects of prolonged antibiotic use, integrative treatment options are often considered. These approaches aim to strengthen the body's immune system to better handle the infection, reduce symptoms, and improve overall health.
Dietary modifications, nutritional supplementation, stress management techniques, and physical therapy can be beneficial. Specific herbal therapies have also shown promise in managing Bartonella infection. Some herbs, such as Sida acuta and Houttuynia cordata, have demonstrated antimicrobial activity against Bartonella species.
Each treatment plan should be individualized, considering the patient's overall health status, co-infections, and therapy response.

Bartonella and Its Relationship with Lyme Disease
Bartonella and Lyme disease, caused by the bacterium Borrelia burgdorferi, often co-exist due to their similar vectors, mainly ticks. This co-infection can complicate the clinical picture as the symptoms of both infections often overlap.
Co-infection with Bartonella can exacerbate Lyme disease symptoms and make the disease more resistant to treatment. Also, Bartonella can exploit the immune dysregulation caused by Lyme disease, leading to persistent and more severe Bartonellosis.
Understanding the interplay between Bartonella and Lyme disease is crucial for the accurate diagnosis and effective treatment of these conditions. Therefore, when Lyme disease is suspected or confirmed, it is important to also consider and evaluate for possible Bartonella infection.