title: Bartonella spp. bacteremia and rheumatic symptoms in patients from Lyme disease-endemic region.
abstract: Bartonella spp. infection has been reported in association with an expanding spectrum of symptoms and lesions. Among 296 patients examined by a rheumatologist, prevalence of antibodies against Bartonella henselae, B. koehlerae, or B. vinsonii subsp. berkhoffii (185 [62%]) and Bartonella spp. bacteremia (122 [41.1%]) was high. Conditions diagnosed before referral included Lyme disease (46.6%), arthralgia/arthritis (20.6%), chronic fatigue (19.6%), and fibromyalgia (6.1%). B. henselae bacteremia was significantly associated with prior referral to a neurologist, most often for blurred vision, subcortical neurologic deficits, or numbness in the extremities, whereas B. koehlerae bacteremia was associated with examination by an infectious disease physician. This cross-sectional study cannot establish a causal link between Bartonella spp. infection and the high frequency of neurologic symptoms, myalgia, joint pain, or progressive arthropathy in this population; however, the contribution of Bartonella spp. infection, if any, to these symptoms should be systematically investigated.
authors.affiliation: North Carolina State University, Raleigh, North Carolina, USA.
authors.forename: Ricardo G
authors.initials: RG
authors.lastname: Maggi
authors.forename: B Robert
authors.initials: BR
authors.lastname: Mozayeni
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Pultorak
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Hegarty
authors.forename: Julie M
authors.initials: JM
authors.lastname: Bradley
authors.forename: Maria
authors.initials: M
authors.lastname: Correa
authors.forename: Edward B
authors.initials: EB
authors.lastname: Breitschwerdt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000382:microbiology; D016470:Bacteremia / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D001473:Bartonella / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D001474:Bartonella Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D058889:Molecular Typing; D012703:Serotyping; D011795:Surveys and Questionnaires; D055815:Young Adult