Bartonellaspp. Bacteremia and Rheumatic Symptoms in Patients from Lyme Disease–endemic Region

• DOI: 10.3201/eid1805.111366
• Publication Date: 2012-03-28T13:35:56Z
• Authors: Ricardo G. Maggi; B. Robert Mozayeni; Elizabeth L. Pult...; Barbara C. Hegarty; Julie M. Bradley; Maria Correa; Edward B. Breitsc...
• Keywords: Adult; Male; 0301 basic medicine; myalgia; Adolescent; Bacteremia; Infectious and parasitic diseases; RC109-216; Young Adult; 03 medical and health sciences; blood; Bartonella Infections; Surveys and Questionnaires; Humans; DNA sequencing; bacteremia; Serotyping; Child; Aged; Aged, 80 and over; Lyme Disease; 0303 health sciences; Research; Arthritis; R; Middle Aged; 3. Good health; Molecular Typing; PCR; Cross-Sectional Studies; arthritis; Child, Preschool; Medicine; Female; Bartonella

Bartonella spp. infection has been reported in association with an expanding spectrum of symptoms and lesions. Among 296 patients examined by a rheumatologist, prevalence of antibodies against Bartonella henselae, B. koehlerae, or B. vinsonii subsp. berkhoffii (185 [62%]) and Bartonella spp. bacteremia (122 [41.1%]) was high. Conditions diagnosed before referral included Lyme disease (46.6%), arthralgia/arthritis (20.6%), chronic fatigue (19.6%), and fibromyalgia (6.1%). B. henselae bacteremia was significantly associated with prior referral to a neurologist, most often for blurred vision, subcortical neurologic deficits, or numbness in the extremities, whereas B. koehlerae bacteremia was associated with examination by an infectious disease physician. This cross-sectional study cannot establish a causal link between Bartonella spp. infection and the high frequency of neurologic symptoms, myalgia, joint pain, or progressive arthropathy in this population; however, the contribution of Bartonella spp. infection, if any, to these symptoms should be systematically investigated.