Neurological manifestations of Bartonella species infections

1.0 CME. This module provides an overview of neurological manifestations reported in association with Bartonella spp. infections.


Edward Breitschwerdt, DVM
Melanie S. Steele Professor of Medicine and Infectious Diseases
Comparative Medicine Institute
NCSU College of Veterinary Medicine


This module provides an overview of neurological manifestations reported in association with Bartonella spp. infections.

Learning objectives

  1. Describe the major neurological presentations that have been associated with infection with a Bartonella species.
  2. List diagnostic strategies that can be used to support a diagnosis of neurobartonellosis.
  3. Discuss potential pathophysiological mechanisms that might contribute to the neurological symptoms reported in association with Bartonella spp. infections.

This session, Neurological manifestations of Bartonella species infections, is approved for 1.0 enduring AAFP Prescribed credit.

AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 credit(s)™ toward the AMA Physician’s Recognition Award. When applying for the AMA PRA, Prescribed credit earned must be reported as Prescribed, not as Category 1.

The AAFP has reviewed One Health Medical Education for a Changing Climate and deemed it acceptable for AAFP credit. Term of approval is from 01/02/2024 to 01/01/2025. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Evidence-based bibliography for further study

Breitschwerdt, E.B., Mascarelli, P.E., Schweickert, L.A., Maggi, R.G., Hegarty, B.C., Bradley, J.M. and Woods, C.W., 2011. Hallucinations, sensory neuropathy, and peripheral visual deficits in a young woman infected with Bartonella koehlerae. Journal of clinical microbiology, 49(9), pp.3415-3417.

Breitschwerdt, E.B., Maggi, R.G., Nicholson, W.L., Cherry, N.A. and Woods, C.W., 2008. Bartonella sp. bacteremia in patients with neurological and neurocognitive dysfunction. Journal of clinical microbiology, 46(9), pp.2856-2861.

Maggi, R.G., Mascarelli, P.E., Pultorak, E.L., Hegarty, B.C., Bradley, J.M., Mozayeni, B.R. and Breitschwerdt, E.B., 2011. Bartonella spp. bacteremia in high-risk immunocompetent patients. Diagnostic microbiology and infectious disease, 71(4), pp.430-437.

Maggi, R.G., Mozayeni, B.R., Pultorak, E.L., Hegarty, B.C., Bradley, J.M., Correa, M. and Breitschwerdt, E.B., 2012. Bartonella spp. bacteremia and rheumatic symptoms in patients from Lyme disease–endemic region. Emerging infectious diseases, 18(5), p.783.

Maggi, R.G., Richardson, T., Breitschwerdt, E.B. and Miller, J.C., 2020. Development and validation of a droplet digital PCR assay for the detection and quantification of Bartonella species within human clinical samples. Journal of Microbiological Methods, 176, p.106022.

Oliveira, A.M., Maggi, R.G., Woods, C.W. and Breitschwerdt, E.B., 2010. Suspected needle stick transmission of Bartonella vinsonii subspecies berkhoffii to a veterinarian. Journal of veterinary internal medicine, 24(5), pp.1229-1232. 

Mascarelli PE, Maggi RG, Hopkins S, Mozayeni BR, Trull CL, Bradley JM, Hegarty BC, Breitschwerdt EB. 2013.Bartonella henselae infection in a family experiencing neurological and neurocognitive abnormalities after woodlouse hunter spider bites. Parasites and Vectors 6, p. 98.

Bradley JM, Mascarelli PE, Trull CL, Maggi RG, Breitschwerdt EB. Bartonella henselae infections in an owner and two Papillon dogs exposed to tropical rat mites (Ornithonyssus bacoti). 2014. Vector Borne Zoonotic Dis. 14: pp. 703-9.

Breitschwerdt EB, Sontakke S, Hopkins S. 2012. Neurological manifestations of bartonellosis in immunocompetent patients: A composite of reports from 2005-2012. J Neuroparasitology 3, pp. 1-15.

Kaufman DL, Koegnik AM, Mozayeni RB, Cherry NA Breitschwerdt EB. 2017. Neurological and immunological dysfunction in two patients with Bartonella henselae bacteremia. Clin Case Reports 5, pp. 931-935. 

Breitschwerdt EB, Maggi RG. Bartonella quintana and Bartonella vinsonii subsp. vinsonii bloodstream infection in a girl from North Carolina, USA. 2019. Med Microbiol Immunol 28, pp.101-107.

Breitschwerdt EB, Greenberg R, Maggi RG, Lews A, Bradley JM.  Bartonella henselae infection in a boy with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). 2019. Journal of Nervous System Disease. 11, pp. 1-8.

Breitschwerdt EB, Bradley JM, Maggi RG, Lashnits E, Reicherter P. Bartonella Associated Cutaneous Lesions (BACL) cutaneous lesions in people with neuropsychiatric symptoms. 2020. Pathogens 9, p.1023.

Lashnits E, Maggi R, Jarskog LF, Bradley J, Breitschwerdt EB, Frohlich F. Schizophrenia and Bartonella spp. infection: a pilot case-control study. 2021. Vector Borne Zoonotic Dis. 21, pp. 413-421.

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Course Includes

  • 1 Lesson
  • 2 Quizzes
  • Course Certificate