Clinician handoff
Bartonella
Designed for a 60-second scan in primary care. Use this to explain why this theory fits, what would weaken it, and which tests are most worth discussing.
Why this still fits
I have a tick or cat-scratch exposure history and symptoms I want to investigate for possible Bartonella - including neurological symptoms or burning pain. I understand standard serology has limited sensitivity and want to discuss whether specialist testing is appropriate given my history.
What would weaken it
- -No credible exposure story and no broader inflammatory, nerve, skin, or pain pattern around the fog.
- -Better-supported causes such as sleep, thyroid, anxiety, Lyme, EBV, or autoimmune disease fit the story more cleanly.
- -The case depends only on vague online symptoms without objective or clinical support.
Key points to communicate
- •I want to know whether bartonella truly belongs in the differential or is being overcalled from internet symptom lists.
- •Please separate this from Lyme, EBV, autoimmune disease, and other inflammatory causes before chasing specialty testing.
- •If bartonella remains plausible, I want to know what evidence would actually move the needle.
Bring this to the visit
- •A timeline of symptom onset and any known exposures: cat scratches, flea bites, tick exposure.
- •Photos of any stretch mark-like striae, especially if they appeared without weight change.
- •Prior Bartonella testing results and any Lyme co-infection panels.
- •Psychiatric symptom log if present: rage, anxiety, mood swings - with timeline.
Useful screening structure
- -Bartonella IgG/IgM serology, though sensitivity is limited.
- -Galaxy Diagnostics ePCR or Bartonella enrichment culture for higher sensitivity.
- -Lyme and co-infection panel since Bartonella rarely travels alone in tick exposure.
Tests and measurements to discuss
Bartonella IFA IgG/IgM (standard serology, ~50% sensitivity)
Enrichment PCR (ePCR) through a specialized reference lab (enrichment PCR - most sensitive available)
Triple-draw blood culture
VEGF level
What this helps clarify: Growth factor that regulates blood vessel formation and oxygen delivery.
Range context
31-86 pg/mL (varies by lab)
How to use the result
Low VEGF is one piece of the CIRS picture; not diagnostic alone.
CBC with differential
What this helps clarify: Core blood count panel used to review white cell patterns, hemoglobin, and platelet context.
Range context
Lab reference interval
How to use the result
Save the result with date and symptoms from the same week.
CRP/ESR (inflammation markers)
Lyme and Babesia co-infection testing if tick exposure history
Questions to ask directly
- •Should we test for Bartonella and co-infections given my exposure history?
- •If serology is negative but clinical suspicion is high, is specialty testing warranted?
- •How long is the typical antibiotic course, and should it be combination therapy?
- •Are my psychiatric symptoms potentially Bartonella-driven, and does treatment help them?
Functional impact snapshot
- -Track fog alongside other symptoms: joint pain, headache, skin findings, mood.
- -Note whether Herxheimer reactions occur with treatment - temporary worsening then improvement.
- -Rate cognitive function before and during treatment at 2-week intervals.
Escalate instead of self-managing if
- •Sudden psychiatric symptoms: psychosis, severe rage, or suicidal ideation.
- •Endocarditis symptoms: new heart murmur, prolonged fever, embolic events.
- •Progressive neurological decline suggesting CNS Bartonella infection.
Peer-reviewed references