#bartonella

[psalm40speakstome]

Prayer Request

A big ask of my chronically ill body and mind this week so prayers would be appreciated for me and my Mom.

Update: I did it! Thanks for praying

[shitpostingmargs]

Ok I’ve never posted before but I’ve decided this is now a goddam shitpost account for when I’m fed up with people and society and my body turning against itself. If you know me, no you don’t keep scrolling.

Also you may or may not get context. Depends on my mood through this typing rant.

Why am I not even 17 yet and the nurses are making jokes I’m a FUCKING GERIATRIC PATENT!?? Like excuse me why am I a goddam 16 year old that has to go to a urologist and get MRI scans and x rays all the time, I’m not some 70 year old I’m SIXTEEN and I’ve been fucked up by a BUG when I was THREE. Lyme disease, bartonella, and some other third thing that’s hiding them IM MY ORGANS. I’m so stressed out from this IM GETTING IBS. SIXTEEN. IBS. How fucking ridiculous is that? And you know what brought this rant on. I’m walking up stairs like a normal goddam person and say “oh dam my back hurts, and my knees, wait I was supposed to take the recycling out this morning wasn’t I?” I have a HERNIATED DISK. SIXTEEN. HERNIATED DISK. Fuck this I can’t sit slouching like I used to because my back will hurt really bad and I start bitching like an old man. I’m pissing my pants at random and praying to whatever sick twisted thing that decided to do this to me that it isn’t going to be at school cuz ya, I still have to deal with that shit still. I can’t use the stairs in my TWO FLOOR SCHOOL and each of my classes are on a different floor. So I have to stand on this elevator looking completely normal on the outside until my chronic illness finally kicks me in the everything and I’m physically and mentally incapacitated because guess what? ITS A BRAIN INFECTION TOO. Fuck this I’m too smart for a therapist they keep saying I don’t need therapy but I need people to just rant about so whoever the hell is reading this you get to be my anonymous therapist now, have a gold star go buy yourself a treat after reading this crashout rant by some randomly chronically ill teenager, you deserve it if you’ve read this far.

[davie-bullck]

Hi tumblr! I know I don’t have a huge following but I’m posting this everywhere for as many eyes as possible. My wonderful roommate Mira has been diagnosed with Lyme disease and many of the tick-borne coinfections. It’s pretty late-stage, so treatment is going to be a long and expensive process. If you’re willing to spare anything or maybe reblog this link to her gofundme it would be greatly appreciated!

Donate to Support Mira's Healing Journey from Late-Stage Lyme Disease, organized by Joy Lynch

In December of 2021, some of you may remember, I got Bell’s pals… Joy Lynch needs your support for Support Mira's Healing Journey from Late-

[flyonthewallmedstudent]

Bartonella henselae

Case Report:

23M veterinary student from home with a cat, presents with a one year history of neck swelling, 1 month of fevers and lethargy. Also he lives in Karachi.

The fevers are a/w chills and rigours that response to paracetamol and have no particular pattern to them.

He doesnt have any arthralgias or arthritis or rash.

They find pretty sizable lymph nodes on exam in the cervical chain and inguinal regions.

He starts developing hypotension and they start him on some vasopressors and meropenem.

The fevers don't respond, and someone decides to start azithromycin, which it does respond to.

He's also worked up for IE given the chronicity of events.

Eventually on biopsy of the lymph node, the lab finds bartonella hensalae.

Microbiology + transmission:

aka cat scratch fever, so this is why history is so important to infectious diseases physicians.

it's actually disease of cats that can spread to their humans via bites and scratches. Or the cat licks a wound etc.

and unfortunately also via arthropod vectors and mossies

after entry into a host, it's main target cells are CD34s, immune cells, and then alters the host immune system

it's interesting special power is that it can predispose hosts to other pathogens in this manner

it's a gram negative rod (pink rods)

Historical trivia

the fun bits

genus of Bartonella is named for a Peruvian scientist (Alberto Barton, also had interest in brucellosis and leishmaniasis --> other tropical diseases taht cause fevers of unclear origin), he isolated the bacteria from patients during an outbreak among railway works in South america. This was 1905.

reminds me of love in the time of cholera, when people still wrote physical letters.

species of bartonella henselae is actually named for Diane Henselae, a researcher from Oklahoma, who collected samples during an outbreak there in the mid 1980s.

rare for someone who discovered a species named for them to be both alive and a woman, and I can't find much about her online.

there are other bartonella species that cause historically significant diseases like trench foot (bartonella quintana, transmitted by lice) and carrion's disease (bartonella bacilliformis, with a high mortality rate). another post for another day.

Clinical features

incubation period: up to 10 days

initial: rash at site of injection or intro of pathogen, from there it travels to local lymph nodes causing lymphadenopathy about 1-3 weeks later

From CDC guidelines who took image from NEJM

Bsymptoms - low grade fevers/malaise/fatigue

epidemio: occurs most often (for a rare disease) in kids < 15

Complications

infection affecting the eye (neuro-retinitis = visual changes, irritation and photophobia), liver, spleen, brain/spine (transverse myelitis, encephalitis etc), bones and heart valves (IE)

Increased risk groups for complications

HIV/AIDs, immunocompromised hosts (i.e. transplants), mortality is an issue in this group, as disseminated disease a possibility

small risk of IE in groups with RFs for develop this (prosthetic valves, damaged valves, unrepaired congential heart disease etc)

Investigations

challenging, no gold standard test as the sens and spec is variable for each individual one, so it's a combination really, of history exam and a variety of confirmatory tests

PCR (variable spec/sens), serology (indirect and often negative in early stages, can also be positive for years post treatment and doesn't differentiate from other bartonella species), cultures are definitive but it can take 21 days for anything to grow (it's fastidious)

histopath of lymph nodes helpful - stains: silver stain or Warthin Starry stain (silver nitrate) which is kind of a reverse starry starry night used for spirochetes like helicobacter.

in IE, it can be culture negative, which can confuse diagnosis

From Wiki

Management

mild disease is self resolving

first line: few days azithromycin or doxycycline can reduce symptoms and is indicated for enlarged lymph nodes to reduce size or unresolving LAD >1 month

in case of eye infection or IE expect longer duration of hterapy, like doxy and rif for 4-6 weeks

will also respond to bactrim, cipro, rif and gent

Prevention from the CDC:

avoid strays, wash hands after petting cats, keep strays from your cat, avoid owning new kittens who are < 1 yr if you are immunocompromised

avoid getting scratched..which is kinda hilarious but can see why

Sources

stat pearls

case report above

wikipaedia

Rare diseases

CDC guidelines

[lymefordummies]

[lifewithbartonella]

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[eatyourdamnpears]

found an old picture of my stretch marks from the end of January 2020 and it’s actually been really reassuring to see that my Lyme treatment has actually had a positive effect on this body of mine

(and yes, I used flash in the after picture, only because it’s what made my stretch marks show up the clearest)

[sir-silly]

my brain is failing me

It has been for a long time. I don’t really know exactly when it started, but it was some time in 2018 that I noticed the change. And it’s killing me.

There’s so many things I used to be able to do. I could write stories for hours on end. I could get so focused on playing a game that the entire day would pass. I could do homework and listen to music at the same time. I could eat dinner with my family without having sensory overload. But I can’t do any of that now.

I have so many thoughts that I want to get out, but it’s like I just can’t. I have all these ideas of stories I want to write, but nothing comes out onto the page. I can’t play the same game for much more than an hour at a time before I need to do something else. I can’t write posts like this and listen to music at the same time because then I can’t think. More often than not, I dread having dinner with my family because I know how overloaded I’ll get.

And I don’t know what changed. I had bartonella, a co-infection of lime disease. I’ve had autonomic dysfunction for years now. But is that what is killing my brain? Is that why I can no longer do the things that used to be easy? Why can’t I think straight or focus on something for extended periods of time? Did my brain really get so messed up that I’ll never get back to how I was? It’s like I’m slowly losing my mind and there’s nothing I can do about it.