Bartonella and peliosis of the liver

[Ricobord]

I was looking at a document on the web about Bartonella and saw something unfamiliar.  It said that Bartonella Henselae and Bartonella Quintana can both cause peliosis of the liver.  I'd never heard of peliosis.

I went to look it up and came across a document that showed a picture of a liver scan that looks just like mine did 18 months ago.  I had a good sized mass that was diagnosed as a focal nodular hyperplasia along with white smudgy spots the radiologist thought was fatty infiltration. I was told this was benign and was not the cause of my terrible liver pain. My GI doc didn't even recommend any further testing for my various GI problems.

While peliosis can be caused by other things (such as oral contraceptives), this document explains how bacillary peliosis (caused only by Bartonella) causes little blood filled lesions which looked like white smudy spots on the CT scan, as well as larger focal lesions like mine.  

It was one of those amazing "Ah, Hah!" moments for me.  The GI doc in the hospital completely missed the fact that my scan was consistent with bacillary peliosis and therefore, I had Bartonella.

At that point, I was trying to convince them I had Lyme and Babesia.  I didn't even know I had Bartonella until a couple weeks later when my IGeneX antibody test showed I had Bartonella Henselae.

Since G. Wormser, head of the IDSA Lyme Committee insists that ticks carry Bart but don't transmit it to humans, I suspect Bart isn't even a consideration in someone with tick borne disease (or like me, claiming to have tick borne disease).  My MS specialist at a nearby university hospital was surprised I hadn't been referred to a hepatic specialist given my ugly looking liver. In hindsight, I don't think she was overreacting. A hepatic specialist might actually have recognized what was going on.

The literature I've seen suggests or says outright that Bartonella is only serious in immune compromised people, such as those with HIV.  Since the IDSA doesn't acknowledge that Lyme can suppress the immune system, and the official dogma says Bart isn't tick borne, I can see why even my highly regarded hospital doc didn't catch it in me.

The link below is to this medical document, which isn't the easiest reading for us lay people. But for someone struggling to get diagnosed who has a liver scan that looks something like one of the examples in this document, it might be a good reference to show a doctor.  

Anyone with peliosis should certainly be tested for all possible variations of Bartonella. Since they can produce false negative results, the new culture test might be a good idea for second tier testing.

http://www.ajronline.org/doi/full/10.2214/AJR.05.0167


P.S. Of course not everyone with Bartonella gets peliosis of the liver.  But it also says:

"Similar blood-filled spaces may be seen in the spleen, lymph nodes, and other organs (including the bone marrow, lungs, pleura, kidneys, adrenal glands, stomach, and ileum). The size of the lesions may vary from 1 mm to several centimeters."

[mojogal]

I just had an ah ha moment. My brain being so foggy completely forgot about the lesions that were found on my liver when I was in Texas 2 years ago.
Thanks for reminding me of this Rico, I am going to have do further research on it.

[youvegottobekidding]

Thanks for his v interesting info.

I have one lesion found on my liver in an ultrasaound scan which the doctor said was a biggish "angioma".
I didn't understand his explanation of what that meant (all in italian) - do you think that could be one of these bart lesions?

And do you think it's worth getting another scan (that one was about 8 years ago!) since I constantly have pain in the region of my liver?

[Ricobord]

I suspect the mention of these lesions also being found in the stomach applies to you, too.  I could easily have had them in my stomach and intestines, but since I was never scoped, I'll never know.

[Ricobord]

I also had a nodule on one adrenal glad and have had chronic adrenal fatigue. I'm now wondering if this was from Bartonella, too.  While a couple different scans of my kidneys don't show any lesions, now I wonder if Bart has contributed to my kidneys being stressed out.

[Ricobord]

I had two big masses. One was the focal nodular hyperplasia. The other was a highly vascular mass of unknown origin, at least 3cm across.  The GI doc says it's benign and not uncommon.  He said not to worry about it.  I almost forgot about it. Now I think it's related to Bart.

The article describes the vascularity of the lesions.  Just search on the word "vascular" in the document. I found three references. You can take a look at the examples and see if any of it sounds like what your scan showed or what your radiologist said.  

(I also have to acknowledge that at least two radiologists also missed my peliosis, not just the GI doc.)

I am very curious as to what my liver looks like now, but I don't want to get the contrast in a scan as that's hard on my kidneys. My GFR is always below the recommended number to get the contrast.  My GP and I decided to wait until I was done with treatment, which is of course taking longer than expected.  Hopefully I can be done with this Babesia in the near future and then I can get the scan done.  

My liver still feels swollen and tender at times, even though I am convinced that my Bart is gone.  It swells up along with my spleen and stomach sometimes when I'm having a Babesia symptom flare.  Babesia is also known to cause an enlarged liver, so I believe that's the current cause.

The article says that appropriate antibiotic treatment resolves bacillary peliosis, so that's very encouraging. (It also warns against misdiagnosing it as a liver abcess, as draining a peliotic lesion can kill the patient!)   I don't know if the masses will disappear completely or not, but my fuzzy spots should all heal up.