HARD SCIENCE ON LYME: Bartonella And Inflammation of the Eye
A new study, "Bartonella and intraocular inflammation: a series of cases and review of literature looks at inflammation of the eye caused by bartonella", by Dr. Kalogeropoulos and colleagues looks at the role of Bartonella in eye inflammation. Eight patients with the diagnosis of Bartonella henselae and two patients with B. quintana intraocular inflammation were identified. Intraocular involvement caused not only by B. henselae but also by B. quintana is being diagnosed with increasing frequency. A high index of suspicion is needed because the spectrum of Bartonella intraocular inflammation is very large.
Purpose: To present various forms of uveitis and/or retinal vasculitis attributed toBartonella infection and review the impact of this microorganism in patients with uveitis.
Methods: Retrospective case series study. Review of clinical records of patients diagnosed with Bartonella henselae and Bartonella quintana intraocular inflammation from 2001 to 2010 in the Ocular Inflammation Department of the University Eye Clinic, Ioannina, Greece. Presentation of epidemiological and clinical data concerning Bartonella infection was provided by the international literature.
Results: Eight patients with the diagnosis of Bartonella henselae and two patients with B. quintana intraocular inflammation were identified. Since four patients experienced bilateral involvement, the affected eyes totaled 14. The mean age was 36.6 years (range 12–62). Uveitic clinical entities that we found included intermediate uveitis in seven eyes (50%), vitritis in two eyes (14.2%), neuroretinitis in one eye (7.1%), focal retinochoroiditis in one eye (7.1%), branch retinal vein occlusion (BRVO) due to vasculitis in one eye (7.1%), disc edema with peripapillary serous retinal detachment in one eye (7.1%), and iridocyclitis in one eye (7.1%). Most of the patients (70%) did not experience systemic symptoms preceding the intraocular inflammation. Antimicrobial treatment was efficient in all cases with the exception of the case with neuroretinitis complicated by anterior ischemic optic neuropathy and tubulointerstitial nephritis.
Conclusion: Intraocular involvement caused not only by B. henselae but also by B. quintana is being diagnosed with increasing frequency. A high index of suspicion is needed because the spectrum of Bartonella intraocular inflammation is very large. In our study the most common clinical entity was intermediate uveitis.
You can read the full study, which is available for free through open access on Dove here.
The LYME POLICY WONK blog is written by Lorraine Johnson, JD, MBA, who is CALDA’s Chief Executive Officer. Contact her at lbjohnson@lymedisease.org.
As many patients and Lyme doctors know, these tick born bacteria ( especially the Lyme spirochete) flock to old injuries. In 2003 I had a horrible life threatening reaction to Tequin, a Fluoroquinoline anitbiotic, that caused severe vasculitis that affected my vision. My vision ( and hearing) never improved after that and I had to wear glasses. When I got Lyme and Bartonella and Babesiosis, one of the first symptoms that I interpreted as being extremely abnormal was that the vision in my left eye had dramatically and suddenly changed for the worse and I felt light headed. I woke up one January morning and there seemed to be a light veil over my vision in that eye and I had been having flashes of light when I blinked. A floater developed as well. The symptoms did not improve until the following May when I ended up in the ER with severe Lyme symptoms and treatment began. My vision is now stable even though the floater is still there but barely noticeable and I still have to wear glasses from the previous damage. I wonder if my left eye was more susceptible to spirochete attack because of the previous damage from the Tequin?
I should also mention that another ‘ initial’ symptom was that my left ear hurt, especially the bone behind the ear and nasal discharge would run out of my nose as if someone was pouring water through my sinuses. My nose wasn’t stuffy and I didn’t feel ill , just had water running out of my nose.