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Bartonellosis: Your Kitten Is Really Cute, But…

This is all about Bartonellosis, an illness you may never have heard of even as doctors are thinking it’s more widespread than anyone thought. Here’s why:
–30% of US households have one or more cat.
–The estimated US household cat population is 86 million.
Feral (outside, not domestic) cats add another 50 million.

136 million cats is a lot of felines.

The Centers for Disease Control (CDC) estimates that slightly less than half this population (46%) carry the bacterium Bartonella, which cats acquire from a flea bite. Obviously cats confined to your bedroom are less likely to be exposed.

Your cat never gets ill from Bartonella, but can transmit the infection to you. The most common way you get infected is from a scratch or a bite. Less often, and unrelated to cats, you can get bitten by a tick, sand fly, or mosquito carrying Bartonella.

The first manifestation of Bartonella infection is a condition called cat-scratch disease (CSD), which can manifest three to ten days after the scratch or bite. Symptoms may include swollen lymph nodes, especially those nearest the scratch. You might also have a rash, fever, headache, and fatigue. When people see a doctor about this, they usually receive antibiotics. But many people just hope it will go away, or they think it’s a case of the flu and tough it out. Indeed, CSD does clear up on its own, with or without antibiotics.

Ominous Bartonella can live on
But now we know there’s more to CSD and Bartonella than meets the eye. Bartonella can live on in the human body for years–decades even–as an opportunistic infection, meaning it can slowly spread almost everywhere but be kept in an inactive/dormant state by a well-functioning immune system.

You can grow old with dormant Bartonella, die of something else, and never even know you were carrying it. But if your immune system is preoccupied elsewhere (such as with physical or emotional stress or another illness) and turns its back, so to speak, on your Bartonella the infection can awaken and begin spreading havoc.

And then, often years after the original scratch, cat bite, or tick bite, the Bartonella can produce a jaw-dropping array of symptoms. In addition to the standard symptoms of any chronic infection (fatigue, fever, swollen lymph nodes, feeling inflamed, brain fog), you might experience the following:
–A variety of bizarre neurologic symptoms (numbness, tingling, vibrating sensations, seizures, headaches, uncontrollable tics, and other body movements), which you might describe to your doctor as just “weird.” Yes, the Bartonella is in your nervous system.
–Because it’s in your brain, you may experience personality changes, mood swings, depression, and being really sensitive to smells, foods, chemicals, lights, touch, and even electromagnetic fields (EMFs).
–Because Bartonella triggers inflammation you might have muscle and or joint pain.
–Gastrointestinal symptoms like heartburn, diarrhea, abdominal cramping.
–And if it attacks your heart, you might have an abnormal heart rhythm, chest pain, and heart murmurs.

With any symptoms like these, you’re clearly heading for your doctor’s office, and although you may look reasonably healthy, you know something is seriously wrong. You try to describe the crawly sensation in your legs, the vibratory buzzing under your skin, and your panic attacks, and while your doctor is trying hard to connect the dots, none of this fits into her framework of the human body and its illnesses.

To make matters worse, you’ve long forgotten about your cat scratch. In fact, the topic of your cat (or the cat you had in college) never even enters the conversation.

Your physical exam and lab work are all normal. If your doc knows what she’s doing, she checks you for Lyme disease, but that test will be negative as well (unless you do have Lyme–you certainly can have both Lyme and Bartonella simultaneously).

Many doctors later…
Generally, it will take a half dozen doctors sometimes months or even years before Bartonella pops into consciousness. Too often your diagnosis is written off as a somatoform disorder, a polite way of saying it’s all in your head. Unfortunately, there are no consistently reliable diagnostic tests for Bartonella and although the treatment (several months of multiple antibiotics) is effective, many doctors are reasonably reluctant to start patients on antibiotics without some sort of diagnostic evidence.

The key test is finding antibodies that your immune system has created against the Bartonella, but (and as a physician I have to say this is immensely frustrating) the bacterium is really good at staying just below your immune system’s radar so that measurable antibody levels are not produced by your body.

Why am I telling you this?

Because the number of patients who suffer unexplained chronic symptoms is enormous. These are the folks who haven’t felt well in years, have endlessly been told “we can’t find anything wrong with you–your tests are normal.” They’ve been tested up the wazoo for Lyme disease (negative, although as I said, you can have both Lyme and Bartonella if the source was an infected tick), mold toxicity, various chronic viruses, environmental toxins, etc, and nothing has been found.

Until a bright idea comes to your doctor and she asks, “By the way, have you ever had a cat?”

Be well,
David Edelberg, MD

Leave a Comment


  1. Thomas says:

    In the ’70s this was called “cat scratch fever.” The word was that it was especially dangerous to pregnant women. For nine months I was tasked with all cat care.

  2. Anissa says:

    I am curious why this bacteria is hosted by cats and small animals, but not dogs. I have cats that have been indoors all their lives, so unless we brought something in on us, it is rare that they would have come in contact with a flea or tick (fleas maybe at the vet). The reason for my comment is that dogs are outside all the time and are continuously exposed to these critters, but they are not affected? I wonder if it has something to do with their physiology?

  3. Ann Raven says:

    This article seems a bit sensationalistic. People who have cats (and dogs) live longer than other people, studies say. I hope suggestible readers will not think attribute any symptoms they may have to their kitties! Having pets is good for you!!!

  4. Barbara Newman says:

    Don’t let this frighten you away from keeping cats! Just keep them indoors and, if they do get outside, make sure they’re treated with flea collars, sprays, etc. until any fleas are thoroughly routed.

    –healthy cat lover

  5. Pen says:

    OK,Doc… I have a house full of rescues and nearly all the symptoms you describe, on and off, for years. But you said A) there’s no test, and B) no cure other than trying multiple antibiotics? What’s a person who’s now scared and convinced to do?

  6. Dr E says:

    Hi Pen
    I didn’t mean to imply there’s “no test,” just that (like many tests in medicine) it is not 100% reliable. You doctor can test for Bartonella antibodies in his office. If the result is ‘if-fy’ you can order this confirmatory test (see link) from Galaxy Diagnostics
    https://www.galaxydx.com/ although it is ‘self-pay’

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Far and away, the commonest phone call/e mail I receive asks about COVID-19 diagnosis.
Just print this out, tape it on your refrigerator door, and stay calm.

ALLERGIES

• Runny nose
• Sneezing
• Red, swollen eyes
• Itchy eyes and nose
• Tickly throat
• No fever

COLD
• Runny nose
• Sneezing
• Sore throat
• Mild muscle aches
• Mild dry cough
• Rarely a low fever

STREP THROAT
• Painful sore throat
• Hurts to swallow
• Swollen glands in neck
• Fever

FLU (Standard seasonal flu)
• Fever
• Dry cough (no mucus)
• Sudden onset over few hours
• Headache
• Sore throat
• Fatigue, sometimes quite severe
• Muscle aches, sometimes quite severe
• Rarely, diarrhea

CORONAVIRUS-COVID 19
• Shortness of breath
• Fever (usually above 100 degrees)
• Dry cough (no mucus)
• Slow onset (2-14 days)
• Mild muscle aches
• Mild fatigue
• Mild sneezing

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