Sunday, November 23, 2014

Bartonella causing liver disease

At our Lyme support meetings, we of course often talk about our coinfection test results, and about the multi-pronged approach to treating Lyme disease, since coinfections are common in the same patient. There are  many known coinfnections that come along in the same tick, and more are being discovered all the time. Not only does the Lyme bacteria itself have three different forms (spirochete, cyst, biofilm), but there are many species of Borrelia. Then, there are the coinfections such as Bartonella, Ehrlichea, Babesia, Cytomegalvirus, EBV, HHV6, Protomyxzoa, and so on, and each of these requires a different drug or herbal regimen for effective eradication or at least reduction. Specialists often disagree over the order in which the different microbes should be attacked,  which ones prevent the others from being effectively treated. That's a big topic. But here's a little side note worth considering:

Below is an abstract of a case study (a single patient) whose liver was infected with Bartonella henselae. It was very difficult to discover the cause of the patient's pain, and then to determine that there was an infection, and that it was  Bartonella. This kind of case study makes me wonder how many bugs we all have running around unchecked in our bodies. 

It  seems to me, more and more, that the best way to get better from all these many coinfections is to do as much bolstering of our immune systems as possible. That is what my homeopath used to say to me, as she was trying (unsuccessfully) to find the right 'constitutional remedy' to reboot my immune system. I wish she had been successful. Often, unfortunately, chronic Lyme patients are so sick that their immune systems are not working correctly and just won't reboot from getting a lot of rest, eating a clean diet, removing heavy metals from the body, doing psychological work to reduce/rethink negative thought patterns that affect the immune system, and so on. 


Granulomatous hepatitis due to Bartonella henselae infection in an immunocompetent patient





Bartonella henselae (B. henselae) is considered a rare cause of granulomatous hepatitis. Due to the fastidious growth characteristics of the bacteria, the limited sensitivity of
histopathological stains, and the non-specific histological findings on liver biopsy, the
diagnosis of hepatic bartonellosis can be difficult to establish. Furthermore, the optimal
treatment of established hepatic bartonellosis remains controversial.


Case presentation


We present a case of hepatic bartonellosis in an immunocompetent woman who presented
with right upper quadrant pain and a five cm right hepatic lobe mass on CT scan. The patient underwent a right hepatic lobectomy. Surgical pathology revealed florid necrotizing granulomatous hepatitis, favoring an infectious etiology. Despite extensive histological and serological evaluation a definitive diagnosis was not established initially. Thirteen months after initial presentation, hepatic bartonellosis was diagnosed by PCR studies from surgically excised liver tissue. Interestingly, the hepatic granulomas persisted and Bartonella henselae was isolated from the patient's enriched blood culture after several courses of antibiotic therapy.




The diagnosis of hepatic bartonellosis is exceedingly difficult to establish and requires a high degree of clinical suspicion. Recently developed, PCR-based approaches may be required in select patients to make the diagnosis. The optimal antimicrobial therapy for hepatic bartonellosis has not been established, and close follow-up is needed to ensure successful eradication of the infection.



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