Copyright c 2010 Dr. Wayne Anderson
Disclaimer: Given the fact that Borrelia and the co-infections all have the same mechanisms of action there is significant symptom overlap. These symptom pictures are meant to be used as templates that will vary given the individual patient’s co-morbidities, strengths and weakness.
Differentiating Bartonella Like Organisms (BLO) from Babesia Like Organisms (BabLO) is like looking at shades of gray. They have many of the same symptoms with different intensities. The main difference between the two is that BLO will be more painful. It likes the joints and periarticular areas. The pain migrates, affecting different joints at different times. It is usually unilateral and gets mistaken for arthritis in its intensity. Keynote for BLO is sensations of pain in the soles of the feet. Headaches are a defining symptom of BLO, as BabLO usually has more head pressure. BLO is not as smart as BabLO, it stays more superficial, affecting skin, and mucous membranes. The skin can have sores like acne, stria, subcutaneous nodules. The skin can have weird sensations like crawling (formication), burning, or other types of neuropathy. The BLO patient will have low grade sore throat, and gastritis. BLO lives in the liver and spleen. It can cause mildly elevated liver enzymes and lymph node swelling. It can cause all the same cognitive, memory, and mood problems as BabLO but not as extreme. When BLO and BabLO come together these symptoms are additive making for a very impaired patient. BLO patients are more hot, and can have low grade fevers, as BabLO tend to chill.
General BLO Considerations:
- Most common co-infection (Dr. Burrascano believes it is more common then Borrelia).
- At this time there are 26 subspecies of Bartonella (Henselae and Cinnuate).
- Can be spread by a tick bite, cat scratch, and flea bites.
- Many cats are infected along with other small mammals and birds.
- Can have acute and/or chronic patterns.
- Remarkably common in patients with chronic neurological symptoms, especially when dominated by pain.
- Fatigue like illness, but “Wired-Tired” (often mistaken for CFIDS).
- All forms of headache: migraine, tension, cluster, mixed type.
- Joint pains, extremities, large and small (knee, shoulders, hands, etc).
- Pain will be wandering, joint to joint, switching side to side, and seldom bilateral.
- Can settle in previously injured joints making them worse and more chronic.
- Can swell a joint (especially knee, fingers).http://www.gordonmedical.com/unravelling-complex-chronic-illness/wp-admin/post-new.php
- Can be mistaken for fibromyalgia.
- More likely to affect surface membranes, causing skin problems, stria, nodular lumps under skin, etc. (Probably involved in Morgellons Disease)
- Gastritis (In the absence of H. Pylori must be next diagnostic consideration).
- Settles in the liver, will compromise liver function, episodically elevating liver enzymes. When liver enzymes are midly elevated (5-20 on ALT and/or AST) without an explanation think Bartonella.
- Lymphadenopathy, often neck but can be in any node depending on individual structure compromise.
- Settles in the spleen, often subtle splenomegaly.
Chronic BLO Symptoms Organized by Organ Systems:
Chief Complaint: Pain, joint pain and/or headache.
- Joint pain, knees, can be large or small joints. Usually wandering, unilateral, can be swollen, seldom hot.
- Often periarticular.
- Minor joint trauma takes forever to heal.
- Headache, can be severe, ice pick, in and around eyes, migraine. Unlike Babesia which has more pressure, weird sensations.
- Same cognitive, memory, emotion symptoms as Babesia but milder, not as disabling.
- These encepalopathic symptom differences between Babesia and Bartonella are an attempt at distinguishing between subtle shades of gray.
- Mild splenomegaly, boggy lymphadenopathy, seldom hard but often painful.
- Worse cervical chains, popliteal fossa, thoracic duct, vague tightness chest, puffy supraclavicular. left over right.
- Painful chest wall, mid to upper sternum.
- Conjunctivitis, pain in and around eyes, intermittent blurred vision.
- Mild sore throat, worse with stress, upon waking, Feels like “just about to get sore throat”.
- Gastritis, dysmotility, worse esophagus, occasional difficulty swallowing.
- Mild hepatomegaly, mildly elevated liver enzymes,
- Gallbladder dysfunction, GERD.
- Right Upper Quadrant (RUQ) pain.
- Rashes, papular, stria, abdominal and upper legs, acne, crusty scalp.
- Subcutaneous nodules, can be tender.
- Crawling, burning ,multiple sensations.
- Sensitive, painful soles, worse getting out of bed and standing, usually bilateral.
- Painful bones of the feet, foot and ankle can both be painful, unlike the soles, is usually unilateral.
Possible Physical Exam Findings:
- Lymph node swelling
- Stria: abdomen, upper legs
- Papulovesicular rash
- Mild Splenomegaly
- Subcutaneous nodules
Possible Acute BLO Symptomatic Presentation:
- Can be asymptomatic between acute episodes.
- “Like the worse flu I ever had!” Can be mistaken for Mono.
- Fever, chills, some sweats.
- Swollen lymph glands, sore throat.
- Hepatosplenomegaly (can cause mildly elevated liver enzymes).
- Significant body aches, joint pains.
- Headache along with other sub clinical encephalopathy symptoms.
- Can last for weeks to months.
- Can have a relapsing acute form for months.
- Can have long dormant stages that are asymptomatic
A curious and dedicated clinician, Dr. Anderson is committed to the ongoing process of learning and teaching. In addition to his clinical practice at Gordon Medical, Dr. Anderson maintained his initial focus on teaching. For over 20 years he taught medical students at Touro Osteopathic Medical School, and supervised residents from Sutter Hospital and interns from the Physician Assistant programs in the clinic setting. He is also a popular speaker on the topics of Lyme disease and neurotoxin illness.