Bartonella is a genus of gram-negative bacteria that can infect humans and other animals. It typically appears in the shape of short rods. Upon entering its human or animal host, it begins to rapidly divide, with a division time ranging from 24 to 48 hours. This rapid division allows Bartonella to efficiently infect various cells within the body, including endothelial cells, microglial cells, macrophages, red blood cells, and immune cells.
There has been a rapid expansion of Bartonella species in the last 30 years. In 1990, only three species of Bartonella were identified. By 2020, over thirty-seven species had been identified. The most common species that infect and cause disease in humans include Bartonella henselae, Bartonella quintana, Bartonella bacilliformis, Bartonella koehlerae, Bartonella elizabethae, and Bartonella vinsonii berkhoffii. To completely rule out Bartonella, testing for all species should be conducted. In my opinion, one of the largest mistakes in healthcare is the failure to test for Bartonella, and when testing is conducted, it often involves insensitive methods and fails to test for all species.
Bartonella can be contracted from eight known vectors. The most commonly known vector is cats, as Bartonella is often referred to as 'Cat Scratch Fever.' The next most common vector is ticks. Many parents are in disbelief that their child could have Bartonella since they never found a tick on them. However, Bartonella can be transmitted gestationally from the mother. There is also evidence that it can be contracted from mosquitoes, sand flies, lice, fleas, and spiders.
Prevalence of Bartonella in Children
Approximately 13,000 cases of Bartonella are diagnosed in the US annually. Children under the age of 14 years old account for 32.5% of all cases, with the highest incidence observed among children aged 5-9 years.
This is likely a gross underestimation since Bartonella is not commonly tested for, leading to misdiagnoses and underreporting of cases in both children and adults. Evidence supporting this includes a research article that investigated the prevalence of antibodies to Bartonella henselae among symptom-free children living in central Italy. The results revealed that over 60% of children had antibodies to Bartonella, suggestive of exposure (Massei et al., 2004).
A retrospective study published in the Journal of Pediatrics examined known infectious etiologies in 231 children with encephalitis in Houston. The results indicated that the most common bacteria associated with encephalitis in children was Bartonella (Erickson et al., 2020). However, Bartonella is still not commonly tested for by medical providers.
Cat Scratch Disease:
- Papule or pustules at the site of inoculation within 7-10 days
- Lymphadenopathy near the site
- Fever
-
Malaise
Additional symptoms of acute Bartonellosis:
- Neuroretinitis
- Encephalopathy
- Endocarditis
- Hepatitis
-
Bacillary angiomatosis
These are the symptoms most commonly identified with Bartonella. However, many symptoms associated with Bartonella are often overlooked or misdiagnosed as other disorders.
Other symptoms of Bartonella include the following:
- Relapsing low-grade fevers
- Blurred vision, photophobia, eye irritation
- Bone pain
- Pain in the soles of the feet
- Anemia
- Dizziness
- Sleep disturbances
- Memory loss
- Cognitive impairments
- Migratory neuropathy and fasciculations
- Alcohol intolerance
- Muscle and joint pains
- Gastrointestinal disturbances
- Headaches
-
Autoimmune thyroiditis
In children, Bartonella symptoms often present as neuropsychiatric issues. This makes it difficult to identify as they are often categorized as mental disorders or behavioral issues, rather than being recognized as an underlying infection contributing to neuroinflammation resulting in neurobehavioral symptoms.
Bartonella Symptoms in Children:
- Rage and aggression
- Constant and daily 'flare-ups'
- Anxiety and/or depression
- OCD
- Brain fog
- Impaired executive function and processing speed
- Sensitivities to light and sound
- Decreased memory
- Headaches
- Stomach aches
-
Stretch marks that blanch when pressure is applied to them.
To effectively eliminate Bartonella, treatment must be implemented for a prolonged period of time, which can last for years. Although this may be discouraging, symptoms should improve during treatment. The reason for continuing treatment for extended periods is to fully eradicate the infection from the body. While there is no guarantee that one will never become exposed again, it is possible to eliminate current infections as long as treatment continues for a sufficient duration.
My preference is to use antimicrobial herbals to treat Bartonella. In my clinical experience, I do not see a difference in the length or success of treatment between those who use antibiotics and those who use antimicrobial herbals. Due to concerns about the prolonged use of antibiotics and the length of treatment needed, antimicrobial herbals are sufficient and effective at achieving desired results and are often better tolerated.
The top three antimicrobial herbals for Bartonella are the following:
-
Japanese Knotweed: It is the number one herbal against Bartonella, effective against all phases of the infection. It also inhibits the cytokine cascade initiated during infection.
-
Cryptolepis: This is a necessity for Bartonella treatment, containing diverse bioactive compounds, including alkaloids such as cryptolepine and quindoline, which provide antimicrobial properties. It is active against all phases of Bartonella, including the stationary non-growing phase and the growing log phase.
- Houttuynia: This herb has antimicrobial benefits against Bartonella. Bartonella is responsive to immune cells called CD4+ cells. Lower numbers of these cells allow Bartonella to invade the body more easily and produce stronger symptoms. Houttuynia helps increase CD4+ immune cells, aiding in the fight against Bartonella.
It is important to work with your child’s healthcare provider when implementing antimicrobial treatment.
REFERENCES
- Erickson, T. A., Muscal, E., Munoz, F. M., Lotze, T., Hasbun, R., Brown, E., & Murray, K. O. (2020). Infectious and Autoimmune Causes of Encephalitis in Children. Pediatrics, 145(6), e20192543. https://doi.org/10.1542/peds.2019-2543
- Laldinsangi C. (2022). The therapeutic potential of Houttuynia cordata: A current review. Heliyon, 8(8), e10386. https://doi.org/10.1016/j.heliyon.2022.e10386
- Massei, F., Messina, F., Gori, L., Macchia, P., & Maggiore, G. (2004). High prevalence of antibodies to Bartonella henselae among Italian children without evidence of cat scratch disease. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 38(1), 145–148. https://doi.org/10.1086/379824
- Mills-Robertson, F. C., Aboagye, F. A., Duker-Eshun, G., Kaminta, S., & Agbeve, S. (2009). In vitro antimicrobial activity of Cryptolepis sanguinolenta (Periplocaceae). African Journal of Pharmacy and Pharmacology, 3(9), 476-480.
- Zhang, Y., Alvarez-Manzo, H., Leone, J., Schweig, S., & Zhang, Y. (2021). Botanical Medicines Cryptolepis sanguinolenta, Artemisia annua, Scutellaria baicalensis, Polygonum cuspidatum, and Alchornea cordifolia Demonstrate Inhibitory Activity Against Babesia duncani. Frontiers in cellular and infection microbiology, 11, 624745.