Bartonella Rash reappearing...

[soxfan]

I live in NC but my Lyme doctor is in NH. Back in October I started on abx again for what I presumed was my Lyme symptoms coming back. A month after on abx a rash appeared on my back which is where I was originally bit in June of 2012. We took pictures to show the doctor. It was blotchy, streaky and had "cat scratch" like marks.
It would last 4 or 5 days then scab over and disappear. This went on every month and we were sure to take pictures.

I wasn't feeling any better on the abx so when I went to see my doctor last week I had every intention of giving up the meds and saying thanks to the doctor. Well on the day of my appt. luckily the rash was in full bloom. He finally got to see the rash in person and said immediately it was a Bartonella rash.

He has now put me on Rifampin and Factive which is a combo I have not had before. I previously was on Zithro and Bactrim which did nothing.

I still feel that CFS is my main illness and no amount of abx is going to help with my most disabling symptoms. I will give this another go and see if it helps in any possible way. Even 10 percent would be a help....I am not sure why this rash keeps appearing but seems to only happen when I am taking abx so I am assuming the meds are stirring up the infection and presenting itself as a rash or it is a herx appearing as the rash.

 

[bmoberg337]

I Bactrim which did nothing.

I still feel that CFS is my main illness and no amount of abx is going to help with my most disabling symptoms. I will give this another go and see if it helps in any possible way. Even 10 percent would be a help....I am not sure why this rash keeps appearing but seems to only happen when I am taking abx so I am assuming the meds are stirring up the infection and presenting itself as a rash or it is a herx appearing as the rash.

I think you are on the right track. ILADS suggests the use of a bactericidal abx along with an intracellular abx (specifically 2nd-3rd generation quinolones).
http://www.ilads.org/lyme/treatment-guideline.php

The first combination your doctor put you on did not include an intracellular abx which is a problem because Bartonella is an intracellular pathogen.

I was on cipro and clarithromycin for 4 months and had a remarkable drop in my antibody levels to bartonella, but without symptom improvement. I have now been on zithro and tinidazole for 3 months and the infection continues to resolve but has not been eliminated. All this to say that it takes time and is definitely worth eradicating. It may also be worth your time to see if you have any other co-infections.

 

[Ema]

It looks like you're on a good Bart combo now!

Rifampin can increase cortisol clearance so if you have adrenal issues, be mindful of the symptoms of low cortisol and discuss with your doctor if you see any worsening.

J Antimicrob Chemother. 2006 Oct;58(4):784-8. Epub 2006 Aug 17.
In vitro susceptibility of Bartonella species to 17 antimicrobial compounds: comparison of Etest and agar dilution.
Dörbecker C1, Sander A, Oberle K, Schülin-Casonato T.
Author information

Abstract
OBJECTIVES:
In vitro susceptibility testing of 31 Bartonella spp. strains including 21 Bartonella henselae isolates was performed for 17 antimicrobial agents (telithromycin, four macrolides, five fluoroquinolones, five aminoglycosides, doxycycline and rifampicin).

METHODS:
MICs were determined by agar dilution and Etest using chocolate agar containing 5% defibrinated sheep blood as assay medium. Longer incubation periods of 3-5 days in a humid atmosphere with 5% CO(2) were required until bacterial growth became visible and MICs could be read.

RESULTS:
The ketolide telithromycin was the most active agent exhibiting the lowest MICs. The Bartonella spp. were also highly susceptible to macrolides, particularly clarithromycin, and to doxycycline and rifampicin, with MICs of <or=0.12 mg/L. Gatifloxacin, gemifloxacin and moxifloxacin were the most potent fluoroquinolones, with MICs ranging from 0.06 to 2 mg/L. Netilmicin was the most active agent among the aminoglycosides. Etest MICs correlated well with MICs determined by agar dilution.

CONCLUSIONS:
Telithromycin, macrolides, doxycycline and rifampicin were the most effective agents against Bartonella spp. Our data confirm that Etest may be a reliable method for determining susceptibility of Bartonella spp.

 

[Ema]

The first combination your doctor put you on did not include an intracellular abx which is a problem because Bartonella is an intracellular pathogen.

Azithromycin is an intracellular antibiotic. However, it may not be the best choice against bart.

It seems to be somewhat more effective when combined with Plaquenil or amantadine to increase the intracellular pH.

 

[Sushi]

He has now put me on Rifampin and Factive which is a combo I have not had before.

How is the Rifampin going? This is a drug I had to "ease into" raising the dose slowly to tolerate it.

Rifampin can increase cortisol clearance so if you have adrenal issues, be mindful of the symptoms of low cortisol and discuss with your doctor if you see any worsening.

My doc asked me to do a cortisol test because of this. Well, the kit is still sitting there but I'll do it soon.

Sushi

 

[soxfan]

I have been on Rifampin before....I never really had any problems with it other than it use to interfere with my sleep medication. I no longer take Lunesta so I won't have any issues with that. I haven't started it this time around yet because the pharmacy had to order the Factive which won't be in until tomorrow.

I really don't have much confidence that I am going to feel better since I still believe my major symptoms are CFS related but I am willing to give it another try.

I have also had at least 3 cortisol tests done over the years and no matter what I am taking (example cortef) my levels never change so I am not too confident in those tests....

 

[JaimeS]

Weird experience in response to my (admittedly heavy-duty) probiotics: I had a rash re-appear at the site of a bite. It's a bull's-eye rash that I thought might be Lyme. It just... reappeared a few days into probiotic treatment. It's definitely not a 'second' bite, it's in the exact same spot.

Could this be Bartonella? And does anyone know WHY this is happening? It seems really weird to have a re-activation of the initial immune response as part of the bacteria dying off, doesn't it?

[Edit: I am taking a pretty high dose of Lactoferrin, too; this could actually be immune re-activation at the site.]

-J

 

[JaimeS]

Finding out more, I discovered a study with some very smug experts who state that this is the result of a second bite rather than the same infection, and that doctors should "keep doing what they're doing" because this "proves" there is no such thing as chronic lyme.

Welll, mine's in the exact same spot, so no.

Wow, my hand slipped so those three faces are totally random, but strangely appropriate.

-J

 

[Valentijn]

My Bartonella rash spreads when I start new antibiotics which impact it. The first time was several years pre-ME, then when taking doxycycline for a long-term sinus infection after being sick for a couple years, and again when I started Lyme and then Bartonella treatment.

Some of them come through my skin, creating an open sore which then scabs over. But that's only started pretty recently, with Bartonella-specific treatment.

I don't know where my infecting tick bite was. I had dozens, maybe even hundreds of tick bites while living in the woods in Southern Oklahoma for two years.

 

[JaimeS]

I can't 'like' that you got hundreds of tick bites, @Valentijn , but I appreciate you sharing your story!

-J

 

[soxfan]

I haven't had any break out of the rash in months but I don't feel any better...being on the rifampin and levaquin totally stopped the rashes from appearing. I still have the same symptoms though...chronic fatigue...nerve pain...overstimulated nervous system...poor quality sleep. I quit all medications months ago because the doctor advised me too.. The only thing they did was give me relief from the rashes on my back where the original bite was in 2012.

 

[JaimeS]

The 2013 bite mark is still there as of today. It doesn't look like it's getting any better.

 

[JaimeS]

Searching for some other reason, I found this post. The bite is gone now, even though I'm still taking probiotics and Lactoferrin.

Lactoferrin is a pretty heavy-duty immune activator, or it was for me, despite the fact that it is OTC. There was a bit where I was dividing the powder in half and putting it back into smaller gelatin pills, but I didn't have to do this for long. Now I'm pretty tired without it.