BARTONELLA EDUCATION
Updated: 6d
Bartonella articles all in one place. These can be printed and handed to doctors, so they can start researching and understanding this infection.
Short on time or energy? A quick-view graphic with the key points is at the bottom of this post.
My short educational video on what Bartonella is and the symptoms it causes:
Bartonella - possible solutions:
WHAT IS BARTONELLA?
Bartonella is a group of bacteria. NC State researchers say there are at least 45 known species, and 18 of them have been found to infect people. The best-known species is Bartonella henselae, the cause of cat scratch disease.
Bartonella can hide inside cells, which is one reason it can be so hard to find on tests, as Dr. Todd Maderis explains.
HOW IT SPREADS
Cats are the main carriers of Bartonella henselae, and cat fleas spread it between cats. Dr. Edward Breitschwerdt of NC State explains that flea droppings get into a cat's nail beds and saliva, so a scratch is the most common way people get it. Dr. Rosalie Greenberg notes that infected cats can carry the bacteria for up to three years.
Other possible routes include lice, sand flies, biting flies, animal bites and mother to baby. Dr. Robert Mozayeni, a Bartonella specialist, says most of the Bartonella patients he has seen got it from fleas and cats.
Bartonella is often listed as a co-infection of Lyme, and Global Lyme Alliance notes it's being found more and more in people who have Lyme. Whether ticks pass it to people is still being studied. ILADS says the evidence for tick transmission is growing but not yet proven, and LymeDisease.org says there's strong suspicion that ticks spread it to people, though more research is needed. Dr. Richard Horowitz lists ticks as a probable carrier.
WHY IT MAY SHOW UP WITH LYME
Bartonella is also known for cat scratch disease, so it's fair to wonder how it connects to Lyme. Dr. Breitschwerdt explains that most healthy people clear Bartonella on their own, while people with weakened immune systems are more likely to get sick from it. Dr. Horowitz finds Bartonella in many of his chronically ill patients. He believes Lyme can weaken the immune system, and that Bartonella can flare up when the immune system can't keep it in check. That is his clinical view, and more research is needed.
In a large LymeDisease.org patient survey (2014), Bartonella was the second most reported co-infection, at 28%.
WHAT BARTONELLA EXPERTS SAY
- Dr. Robert Mozayeni, a Bartonella specialist and past president of ILADS: when his team biopsied the red stretch-mark-like lesions, they turned out to be Bartonella every time, though he says larger studies are needed to prove it. He says people who have had Bartonella a long time may not make antibodies (about 20% in his experience), so he puts the most weight on tests that look for the germ itself, like PCR and FISH.
- Dr. Rosalie Greenberg, a child and adolescent psychiatrist: Bartonella can cause moodiness, oppositional behavior, severe agitation, anxiety, panic, hallucinations, and depression that doesn't respond to the usual psychiatric medications. It can also slow thinking and memory, which can hurt a child's schoolwork. She points out that a person can test negative and still have Bartonella, and urges readers to keep Bartonella on their radar, since their doctor may not.
- Dr. Edward Breitschwerdt of NC State: Bartonella is hard to grow and culture in the lab, and testing for it is complicated.
- Dr. Monica Embers of Tulane says Bartonella and Lyme are both "notoriously difficult to detect and treat" (2021).
- Dr. Brian Fallon of Columbia University: research supports a link between Bartonella and psychosis, but a link doesn't prove Bartonella is the cause.
MOST COMMON SYMPTOMS
These are the symptoms Lyme literate doctors and Lyme organizations mention most:
- Pain in the soles of the feet and the shins, and other bone pain
- Anxiety, depression, rage, OCD and other psychiatric symptoms that can be severe
- Swollen lymph nodes
- A rash that looks like stretch marks, sometimes called Bartonella striae or tracks
See pictures of Bartonella striae:
(Dr. Maderis notes they're especially likely to run horizontally on the back and hips)
- Headaches and migraines
- Bladder pain or urgency
See my full symptom list:
WORTH MENTIONING
These come from older sources, so more research is needed:
- Gastritis: Dr. Joseph Burrascano listed gastritis among possible Bartonella symptoms (2010), and Dr. Wayne Anderson, ND, wrote that he believes most gastritis not caused by H. pylori is often caused by Bartonella (2017).
- Teeth: Dr. Mozayeni has reported seeing a very high number of root canals in his patients, possibly from poor blood flow to the tooth, as Better Health Guy shared in 2015.
TESTING
Dr. Marty Ross explains that many tests miss it, so a negative test doesn't rule it out. ILADS notes that testing for co-infections can be challenging, and ILADEF, a sister organization of ILADS, says tests such as immunoblots, FISH and PCR can help confirm what a doctor already suspects. Still, some people need a positive test for their own peace of mind. I know I wanted that.
Specialty labs often used for Bartonella testing:
- Galaxy Diagnostics: their Bartonella testing panel combines a DNA test (digital PCR), an enrichment culture that helps the bacteria grow before testing, and an antibody test for 4 species. Galaxy reports that patients are 2.5 times more likely to test positive on its DNA test with a triple draw (three blood samples) than with a single draw.
- IGeneX: offers IgM and IgG ImmunoBlots for 4 Bartonella species, plus several other tests, including a new culture-enhanced PCR. Dr. Ross prefers the IGeneX ImmunoBlots.
- TLab: a lab in Maryland that offers an RNA FISH blood test for Bartonella. Ask your practitioner to order it.
Leading Bartonella experts are behind these labs: Galaxy was co-founded by NC State researchers Dr. Edward Breitschwerdt and Dr. Ricardo Maggi, and TLab was founded by Dr. Robert Mozayeni.
TLab and Galaxy are the labs mentioned most often in our groups for Bartonella testing ordered by people's doctors. A clinical diagnosis, based on specific symptoms and history, is also common. Some feel TLab has now passed Galaxy in picking up Bartonella. Over the next year, I'll keep gathering what Bartonella specialists say about this.
Every Lyme doctor has their own testing preferences, and that's okay.
My Lyme and co-infection testing post:
NEW RESEARCH
- Psychosis: a 2024 study by NC State and Columbia University found Bartonella DNA in the blood of 43% of adults with psychosis, compared with 14% of adults without psychosis. Antibody tests didn't show this difference, and the researchers note this link doesn't prove Bartonella causes psychosis.
- Hidden in the brain: a 2025 NC State case found Bartonella DNA in a child's brain tissue, even though the child's blood test had been negative months earlier.
- A whole family: a 2025 NC State study found Bartonella in all five members of one family, and in their pets.
- Tulane research: Dr. Monica Embers of Tulane and her team, working with NC State, developed a mouse model in 2024 that can be used to study Bartonella treatments in the future. In 2022, Global Lyme Alliance began raising funds for her Bartonella Discovery Program, to study why antibiotics don't always clear Bartonella (including how bacteria living inside cells and in biofilms respond to treatment) and to look for Bartonella in kids and young adults with PANS and in older adults with dementia.
- "Sleeping" bacteria: a 2024 lab study found that a low-grade fever temperature and certain antibiotics pushed Bartonella henselae into a dormant state. In this state it stayed alive but could not be grown in the lab, and it was harder to kill with antibiotics. This may help explain why it can be hard to find on culture tests and hard to treat.
- New drugs: in 2021, the Steven and Alexandra Cohen Foundation funded a $4.8 million Bartonella research team at Tulane, Duke and NC State to find new treatments.
TREATMENT
Treatment is covered in my natural solutions post. Every Lyme literate doctor has their own approach, so work with yours.
RELATED RISE ABOVE LYME POSTS
BARTONELLA MOST COMMON SYMPTOMS
BARTONELLA - POSSIBLE SOLUTIONS
TRANSMISSION OF LYME, BABESIA AND BARTONELLA
LYME DISEASE AND CO-INFECTION TESTING
SOURCES
Lonnie Marcum, "How prevalent is Bartonella in people who have Lyme disease?" LymeDisease.org (2022, updated 2023)
Dr. Rosalie Greenberg, "Bartonella - The Stealth Pathogen That Can Be 'Seen' Without a Microscope," Global Lyme Alliance (2022)
"The Misunderstood Infection that is Wreaking Havoc," with Dr. Edward Breitschwerdt, Bay Area Lyme Foundation (2023, updated 2024)
ILADS, "Lyme Disease Basics for Providers"
ILADEF (ILADS's sister organization), "Tick-Borne Diseases Other Than Lyme" (2024)
LymeDisease.org, "Bartonella" (2022)
Dr. Richard Horowitz, "Medical Detective: Bartonella, Part 1," LymeDisease.org (2025)
NC State News, "Bartonella and Babesia Co-Infection Detected in Patients with Chronic Illness" (2024)
Global Lyme Alliance, Bartonella
Delaney et al., "Bartonella species bacteremia in association with adult psychosis," Columbia University and NC State, Frontiers in Psychiatry (2024)
NC State News, "Bartonella DNA Found in Blood of Patients With Psychosis" (2024)
Breitschwerdt et al., "Bartonella henselae, Babesia odocoilei and Babesia divergens-like MO-1 infection in the brain of a child with seizures, mycotoxin exposure and suspected Rasmussen's encephalitis," NC State, Journal of Central Nervous System Disease (2025)
Breitschwerdt et al., "A One Health Zoonotic Vector Borne Infectious Disease Family Outbreak Investigation," NC State, Pathogens (2025)
NC State University News, Bartonella case studies (2025)
Bullard et al., "A comparison of Bartonella henselae infection in immunocompetent and immunocompromised mice," Tulane University with NC State, PLoS ONE (2024)
Gou et al., "Viable but nonculturable state in the zoonotic pathogen Bartonella henselae induced by low-grade fever temperature and antibiotic treatment," Frontiers in Cellular and Infection Microbiology (2024, lab study)
Global Lyme Alliance, "Global Lyme Alliance Launches Crowdfunding Campaign for Groundbreaking Bartonella Research" (2022)
Global Lyme Alliance, "The Steven and Alexandra Cohen Foundation Announces Funding of Bartonella Research Consortium" (2021, older source, still worth reading)
Global Lyme Alliance, "Patients Share Their Lyme and Bartonella Stories" (videos)
Galaxy Diagnostics, "Bartonella Testing Panel" and "Enhanced BBB Direct Detect (dPCR) Method" (2026)
IGeneX, "Diagnostic Tests for Bartonella" and "Bartonella IFA vs. Bartonella ImmunoBlot Tests" (2022, updated 2023)
TLab, Gaithersburg, Maryland
LymeDisease.org, "Bartonella," citing Dr. Joseph Burrascano (2010, older source)
Dr. Wayne Anderson, ND, excerpt from New Paradigms in Lyme Disease Treatment, LymeDisease.org (2017, older source)
Scott Forsgren (Better Health Guy), "Unraveling the Mystery of Bartonellosis," Townsend Letter (2015, older source)
TLab, About Us
Dr. Robert Mozayeni, interview with Better Health Guy, Episode 185 (2023)
Ericson, Mozayeni et al., "Bartonella- and Borrelia-Related Disease Presenting as a Neurological Condition Revealing the Need for Better Diagnostics," Microorganisms (2024)
Dr. Marty Ross, "How to Diagnose Bartonella in Chronic Lyme Disease" (updated 2026)
Dr. Todd Maderis, "Bartonella: More Problematic than Lyme Disease?" (updated 2023)
Disclaimer: Rise Above Lyme makes no claims about any possible benefit of using any product mentioned within this site. Always consult with your doctor before adding anything. The information shared is based on personal experience, years of accumulated researched resources from Lyme Literate doctors and polls conducted within Lyme groups from actual patient experience using these solution ideas.
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