Thread by @ilads_lyme

Dempsey: Bartonella is a stealth multi-systemic infection transmitted by fleas, biting flies, body louse, mosquitoes and possibly ticks #ILADS2022

2/Dempsey: Objective findings of #Bartonella include fever, rash, swollen lymph nodes, uveitis #ILADS2022

3/Dempsey: #Bartonella is multisystemic and can involve every organ. #ILADS2022

4/Dempsey: #Bartonella can impact the eyes (#uveitis) heart (#pericarditis #myocarditis), joints, vascular system, brain and more #ILADS2022

5/Dempsey: #neuropsychiatric symptoms are often present with #Bartonella infections #ILADS2022 #headaches #encephalopathy #meningitis #aphasia #Schizophrenia #depression #anxiety #bipolar #neuropathy

6/Dempsey: Molecular testing for #Bartonella will be the best option in the future. Serology tests may miss strains not tested for; PCR currently lacks sensitivity (qPCR is better). #ILADS2022

7/Dempsey: #Bartonella is an intracellular pathogen may be widely distributed within tissues. Oral antibiotics work, intravenous therapy not usually needed #ILADS2022

8/Dempsey: Antibiotics are bacteriostatic, not bactericidal: it takes time for the immune system to clear #Bartonella infection. Slow replication cycle, biofilms and tissue cysts may play a role in persistence of infection #ILADS2022

9/Dempsey: Recent practice patterns emerging: Azithromycin or Clarithromycin in combination with Rifampin for #Bartonella treatment. However, beware of drug effects on CYP systems and metabolism of sterol hormones (cortisol, others) when using Clarithromycin / Rifampin #ILADS2022

10/Dempsey: Botanicals such as J. nigra, C. sanguinolenta, and P. cuspidatum have been shown do be effective against stationary phase #Bartonella henselae in vitro. Methylene blue is also showing promise #ILADS2022

11/Dempsey: Ongoing recruiting for #Bartonella tissue study #ILADS2022