Tuesday, August 19, 2008

Do I have Bartonella?

As we go through life with pick up micro-organisms. An untold volume of viruses and bacteria are added to our bodies like barnacles accumulating on the hull of an aging ship. Hopefully the ship will stay afloat. This is the natural order. We evolved to survive in a soup of microbes. Only a few make us sick. Of course that varies. Opportunistic infections. It has a nice ring. These are dormant germs, biding their time, waiting for the right moment or "opportunity"to strike and make their mark. They can only make a move when the ever vigilant immune system has taken some hard hits and dozed off while on guard duty. Of course Bartonella is the most common tick borne infection. This is no surprise. It comes from the bite of fleas, mosquitoes, flies and a host of other insects. It is impossible to avoid. It is a small gram negative, falcultative, intracellular bacteria with an affinity for red blood cells. This means it has a defined cell wall and is hard to culture. The healthy population is exposed all the time. It only gets you if your immune system is on the fritz. Lyme suppresses the immune system. Is that why Bartonella causes problems? Or does it? Unfortunately, the only thing certain about Lyme medicine is that little is certain. The blood tests are inaccurate. The Fry test is inaccurate. The Fry test finds BLOs, Bartonella like organism which are an entirely different matter. These are feline germs without cell walls more related to Mycoplasmas, not known to be transmitted by vectors (ticks). To add to the confusion, Dr. Burrascano and others call the tick borne Bartonella BLOs as well. What is meant here is that tick transmitted Bartonella behaves differently than other forms of the same species commonly associated with Cat Scratch Fever. Did you follow me? Clear as mud. Bartonella can cause a host of very serious illnesses in patients who are immunsuppressed by HIV, alcoholism, malnutrition, cancer and others. This unique Bartonella, associated with LBC (Lyme Borreliosis Compex) is said to have unique features. It doesn't cause the serious Bartonella associated diseases like endocarditis which are well documented in standard medical texts. It causes: More severe psychiatric symptoms, rashes and nodules, Lyme symptoms which are refractory to therapy and other symptoms listed by well known LLMDs. One problem is that all of the purported Bartonella specific symptoms are also seen with Lyme. Lyme causes serious neuropsychiatric symptoms of all sorts. Lyme is associated with all sorts of mysterious dermatologic manifestations and so on. Essentially what we are talking about then is: 1) a germ that everyone gets 2) symptoms which may be caused by just Lyme and 3) no reliable test to confirm that the organism is present or gone. One LLMD claims that treatment is very difficult. Standard therapies are ineffective. Patients should be treated with high doses of both Zithromax and Biaxin in combination. Another very well known LLMD says it should be treated with Levaquin for one to three months. He reports that Rifampin may be an alternative therapy. He claims that since Levaquin doesn't kill Lyme improvement must be attributed to the killing of Bartonella. One little problem. Where are the facts? These are anecdotal reports; there is no science to support them. Both treatment DO KILL LYME. Sorry. Look at the original studies on minimal inhibitory concentration of drugs effective against Lyme. Although Cipro is a more effective quinolone for killing Lyme, its cousin Levaquin also dispatches the little buggers.
Bartonella: We all got it and keep getting it. It is opportunistic. Does Lyme cripple the immune system enough to let it ravage our bodies? If so, why doesn't it cause any of the well known syndromes associated with the organism. Listen Lymeland: Gary Wormser and Allen Steere are gunning for us. Why are we loading their guns with ammo? We know that Lyme is hard to kill and that different antibiotics seem to work better for different patients. The notion of individual patient responses to medicines is accepted in all facets of medicine. If blood pressure medicine A doesn't work perhaps med B will. We can conjecture, theorize and pontificate regarding our beliefs that Bartonella may do this or that. But we need to be clear that we are just throwing out theories. When we start writing down symptom lists and medication lists, without the backing of science we are acting like, gee, the ID... As a favorite med school professor said: " Call 'em like you see 'em."

9 comments:

Lyme report: Montgomery County, MD said...

Will someone please give me grief over this blog. The lack of response makes me think I am right. I am sure that most Lyme patients and LLMDS think that Bartonella and its treatment are critical.

I am hoping that a new PCR test will help me find it.

humboldt county, cd said...

I was just prescribed Levaquin for Bartonella and am presently on doxycycline for suspected lymes and elevated cp. As you said the Barontella test is inconclusive but it showed up on enough bands to make my physician want to try to treat it. I researched Levaquin and am quite concerned with the side effects of this and floroquines (sp?). I know I have taken Tequin in the past for a sinus infection. The side effects sound just like many of the Lymes symptoms and sometimes worse. I wonder if my symptoms could be attributable to the Tequin and just be longtrem side effects that have essentially grown worse? Have you really heard of someone who is cured of chronic lymes with a long term antibiotic treatment. What is a PCR test and is there a new one?

Andrea Runyan said...
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Andrea Runyan said...
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dark_one said...

My name is Wesley Brown and i would like to show you my personal experience with Zithromax.

I am 45 years old. Have been on Zithromax for 2 days now. I took this drug (generic azithro 500 mg bid) to get rid of an 2+ week old sinus infection that did not clear with decongestants and antihistamines. The drug made a substantial difference within 2 days. I'm a physician and needed to return to work, and the tiredness was just excessive, so I stopped the drug after 48-72 hours. The infection did not return. I would take this drug again if I needed to kill off an infection. I don't expect to feel good all the time. If a drug is making me healthy in a particular way, it's up to me to weigh that benefit against the cost of side effects.

I have experienced some of these side effects -
Fatigue. I just didn't want to move or get out of bed while on the drug; it was a bit hard to figure out that this was an effect of the medication rather than the sinusitis. Otherwise I was fine.

I hope this information will be useful to others,
Wesley Brown

Zithromax Prescription Medication

NiSSeS said...
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NiSSeS said...

You said: "writing down symptom lists and medication lists, without the backing of science we are acting like, gee, the ID... "

I think letting your patient die without fight for his life just because there is no science supporting the treatment is even more acting like the ID...

Seriously. Do you remember how the vaccine was invented? So think again.

cmak said...

I have a theory about the BLO...i think the lyme after awhile just messes with your CNS, so therefore, your feet, that you walk, on and the anxiety maybe all contribute to the lyme, and docs think its BLO. All the literature basically sums down to it being a CNS condition. Maybe it takes awhile for your nerves to recondition themselves as your trying to just kill the lyme and co-infections. Just a thought, maybe since we cant figure out what that mystery bug is that shows in the blood smears, is a co-infection, but maybe just a cross reaction from the mycoplasma? idk..

D said...

Can't give you grief on that one. I think you're right on. I do love Levaquin for Bart and Lyme, but you said it: it hits both, so...? Until taxonomy gets correct (including "BLOs" and that we so desparately need other Bart spp tested by "regular" labs using the correct reagents)... ~sigh~