What dermatologists need to know about Bartonella

Galaxy Diagnostics co-founder Dr. Ed Breitschwerdt on ReachMD with Dr. Michael Greenberg on what dermatologists should know about Bartonella species infections.

Research over the past 30 years has shown that Bartonella species infect a wide array of cell types, including red blood cells and endothelial cells (in particular cells that line the blood vessels), in both people and animals. This interview comes after a series of studies that Dr. Breitschwerdt and other researchers published that suggested the skin could be another area where Bartonella species persist in certain patient populations. These studies included:

• A 2019 case report described a boy presenting with severe neuropsychiatric symptoms and skin lesions who was not improving on standard anti-psychotic drugs. His neuropsychiatric symptoms resolved after testing positive for a henselae bloodstream infection and being treated with combination antimicrobial therapy. The skin lesions resolved as well.
• A couple of 2020 studies further described the relationship between Bartonella, skin lesions, and people presenting with neuropsychiatric symptoms. One study found that of 29 participants who had DNA and/or antibody evidence of Bartonella species infection, 24 reported skin lesions that appeared around the time of neuropsychiatric symptom onset. Another study took biopsies from affected areas of skin on patients with neuropsychiatric symptoms and used an advanced microscopy technique to visualize B. henselae.

Listen here:

→Dr. Breitschwerdt discusses Bartonella-associated skin lesions here (13 minutes): https://reachmd.com/programs/dermconsult/bacteria-in-bartonella-what-we-need-to-know/12221/

→Dr. Breitschwerdt describes Bartonella infections as a hidden epidemic here (4 minutes): https://reachmd.com/programs/dermconsult/unpacking-an-epidemic-within-an-epidemic/12253/

Transcripts for each interview are available at the links.

References

Breitschwerdt, E.B., et al. (2020) Bartonella associated cutaneous lesions (BACL) in people with neuropsychiatric symptoms. Pathogens. 9(12), 1032
https://www.mdpi.com/2076-0817/9/12/1023/htm

Breitschwerdt, E.B., et al. (2019) Bartonella henselae bloodstream infection in a boy with pediatric acute-onset neuropsychiatric syndrome.  Journal of Central Nervous System Disease. 11: 1179573519832014.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6423671/

Azar, M., et al. (2020). Imaging analysis of Bartonella species in the skin using single-photon and multi-photon (second harmonic generation) laser scanning microscopy.  Clinical Case Reports. 8(8): 1564-1570.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455430/