If the insurer determines Bartonella is not part of your chronic condition,

The information below may help support the diagnosis.


LB [Bartonella and Bartonella-like organisms are emerging infectious tick borne diseases. Severe clinical forms of B. henselae infections have been reported in patients coinfected with other infectious organisms, such as Borrelia and Esptein-Barr virus. My records indicate a positive Bartonella henselae, Qualitative PCR test (give date), from Medical Diagnostic Lab. PCR, as mentioned elsewhere, is the “gold-standard” for serology testing. Your reviewers did not consider or expand on infections caused by Bartonella sp. and the severe consequences and toll it can have on humans and animals. Dismissing the importance of this diagnosis is unconscionable and indicates a purposeful attempt to conceal important facts or an ignorance of the disease and its manifestations for monetary gain.]

Table VII. Miscellanous manifestations of Bartonella henselae infection in humans.

Clinical manifestations References

Tumoral and Pseudotumoral manifestations of CSD

Mimicking breast tumor, breast mass [93, 160]

Granulomatous hepatitis and necrotizing splenitis [150]

Simulating lymphoma [90, 183, 231]

Gammopathy [140]

Simulating rhabdomyosarcoma [161]

Mimicking parotid malignancy [122]

Pseudotumoral presentation [74]

Simulating a malignant process of the chest wall [172]

Peripheral lymphadenopathy [14]

Myelodysplastic syndrome [225]

Joint and/or bone localisation

Arthritis, arthralgy [5, 105]

Osteomyelitis [148]

Skin localisation

Skin nodules, cutaneous vasculitis [206]

Erythema nodosum, granuloma annulare [211]

Petechial, papular and vasculitic skin lesions, [225]

Unusual eruption [146]

Paronychia [202]


Endocarditis [31, 70, 85, 101, 189, 223]

Henoch-Schonlein purpura [9]

Purpura with leukocytoclasic vasculitis [206]

Glomerulonephritis [223]

Periodontitis [55]

“Atypical CSD: From 5% to 9% of CSD cases may develop atypical manifestations, including Parinaud’s oculoglandular syndrome, encephalitis, endocarditis, hemolytic anemia, hepatosplenomegaly, glomerulonephritis, pneumonia, relapsing bacteremia, and osteomyelitis [157]. Cat scratch disease encephalopathy (CSDE), possibly associated with an immune-mediated response to B. henselae infection, is one of the most severe complications of CSD [175].”

Table VIII. Neurologic manifestations of Bartonella henselae infection in humans.

Clinical signs References

Epilepsia partialis continua [188]

Encephalopathy [102, 162, 175]

Status epilepticus [6, 79, 102]

Peripheral facial nerve paralysis [227]

Coma [102]

Fatal meningitis and


[89, 162]

Meningoencephalitis [216]

Meningitis [230]

Hemiplegia [195]

Source: Vet Res. 2005 May-Jun;36(3):383-410. Factors associated with the rapid emergence of zoonotic Bartonella infections. Boulouis HJ, Chang CC, Henn JB, Kasten RW, Chomel BB. Microbiologie-Immunologie, Ecole Nationale Vétérinaire d'Alfort, 7 avenue du Général de Gaulle, 94704 Maisons-Alfort, France. http://www.ncbi.nlm.nih.gov/pubmed/15845231?dopt=Abstract

Last Updated- April 2019

Lucy Barnes