James L. Schaller, M.D.  •  239-263-0133

Do Bartonella Infections Cause Agitation, Panic Disorder, and Treatment-Resistant Depression?

James L. Schaller, MD, MAR; Glenn A. Burkland, DMD; P.J. Langhoff
Medscape General Medicine. 2007;9(3):54. © 2007 Medscape
Posted 09/13/2007



Bartonella is an emerging infection found in cities, suburbs, and rural locations. Routine national labs offer testing for only 2 species, but at least 9 have been discovered as human infections within the last 15 years. Some authors discuss Bartonella cases having atypical presentations, with serious morbidity considered uncharacteristic of more routine Bartonella infections. Some atypical findings include distortion of vision, abdominal pain, severe liver and spleen tissue abnormalities, thrombocytopenic purpura, bone infection, arthritis, abscesses, heart tissue and heart valve problems. While some articles discuss Bartonella as a cause of neurologic illnesses, psychiatric illnesses have received limited attention. Case reports usually do not focus on psychiatric symptoms and typically only as incidental comorbid findings. In this article, we discuss patients exhibiting new-onset agitation, panic attacks, and treatment-resistant depression, all of which may be attributed to Bartonella.


Three patients receiving care in an outpatient clinical setting developed acute onset personality changes and agitation, depression, and panic attacks. They were retrospectively examined for evidence of Bartonella infections. The medical and psychiatric treatment progress of each patient was tracked until both were significantly resolved and the Bartonella was cured.


The patients generally seemed to require higher dosing of antidepressants, benzodiazepines, or antipsychotics in order to function normally. Doses were reduced following antibiotic treatment and as the presumed signs of Bartonella infection remitted. All patients improved significantly following treatment and returned to their previously healthy or near-normal baseline mental health status.


New Bartonella species are emerging as human infections. Most do not have antibody or polymerase chain reaction (PCR) diagnostic testing at this time. Manual differential examinations are of unknown utility, due to many factors such as low numbers of infected red blood cells, the small size of the infecting bacteria, uncertainty of current techniques in viewing such small bacteria, and limited experience. As an emerging infection, it is unknown whether Bartonella occurrence in humans worldwide is rare or common, without further information from epidemiology, microbiology, pathology, and treatment outcomes research.


Three patients presented with acute psychiatric disorders associated with Bartonella-like signs and symptoms. Each had clear exposure to ticks or fleas and presented with physical symptoms consistent with Bartonella, e.g., an enlarged lymph node near an Ixodes tick bite and bacillary angiomatosis found only in Bartonella infections. Laboratory findings and the overall general course of the illnesses seemed consistent with Bartonella infection. The authors are not reporting that these patients offer certain proof of Bartonella infection, but we hope to raise the possibility that patients infected with Bartonella can have a variety of mental health symptoms. Since Bartonella can clearly cause neurologic disorders, we feel the presence of psychiatric disorders is a reasonable expectation.


Bartonella is an infection that may cause a rash, enlarged lymph node(s), and malaise and fatigue that resolve over several weeks.[1,2] Many animals and insects carry this infection. Bartonella has multiple vectors and infection sources including fleas, flea feces, cat licks or scratches, ticks, lice, and biting flies.[3-6] Young stray kittens are often able to infect humans due to flea feces on their paws, or through cat scratches, bites, or licks.[7-10]

Bartonella is found in cities, suburbs, and rural locations,[11-14] and is an emerging infection. In recent decades, Bartonella research publications are increasing, but psychiatric disorders were underreported in the soldiers of World War I and World War II. For example, approximately 1 million soldiers in WWI were affected with Bartonella quintana,[15] but medical journals did not report much about its psychiatric manifestations.

In the last 15 years, 9 Bartonella bacteria have been identified that are known to infect humans: B henselae, B elizabethae, B grahamii, B vinsonii subsp. arupensis, B vinsonii subsp. berkhoffii, B grahamii, B washoensis, and, more recently, B koehlerae and B rochalimae.[16-20] Currently, the largest national laboratories offer tests for only 2 species[21-23] (B quintana and B henselae).

Some Bartonella cases have "atypical" presentations with signs or symptoms lasting more than weeks, causing diverse medical problems. For example, Bartonella can cause vision abnormalities, prolonged fever, joint pain, lung inflammation, respiratory disease, and granulomas throughout the body. It can occasionally cause abdominal pain, liver and spleen tissue abnormalities, thrombocytopenic purpura, bone infection, papules or pustules, maculopapular rashes, arthritis, abscesses,[20, 24-30] heart tissue and heart valve problems,[31-37] and neurologic illnesses.[38-42]

Traditionally, cognitive neurology has been related to some psychiatric illnesses. A search of PubMed with "Bartonella " and the search words "depression," "mania," "bipolar," "major depression," "depression," "anxiety," "panic," "panic attack," "psychosis," and "schizophrenia" yielded the limited journal results below:

To read this entire article you can go to: www.medscape.com/viewarticle/562276_print

You might have to resister for this free article but that only takes a couple minutes. They do not torture you with 50 questions. It is a good journal. Sorry I can only offer some initial quotes, but the full article and extensive references are free.

Our research shows Bartonella causes every type of psychiatric problem and since it is on blood cells and also enters the walls of blood cells it can cause over 200 problems´┐Żfor example 15 in the eyes and about 15 in the heart.

I am currently doing a new large book on Bartonella with new treatments, why traditional and alternative treatments fail, and new testing with patent pending material that is exciting. We also have collected about 20 different types of rashes associated with Bartonella.

We have a new book coming out in December called, The 12 Reasons Lyme Disease Treatment Fails, and it will include quite a bit of Bartonella and Babesia material.

Link is: www.personalconsult.com/articles/12reasonsprepub.html

Some of the Babesia material in this new book is not in my Babesia textbook and is very new research we have done on treatment cures. We have found with Bartonella and Babesia much is wrong in dosing and treatment options, and so we offer the results of diverse blind research treatments which led to cures.