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Tick-Borne & Infectious

Bartonella Infection Clinical Trials and Treatments

Also called Bartonellosis, Bartonella, Bartonella henselae infection, Bartonella quintana infection, trench fever, Carrion's disease

Bartonella are gram-negative bacteria that live inside cells, especially the cells lining blood vessels. More than 20 species are known, and 3 are established causes of human disease.

FDA-approved medicines

4

Vibramycin, Demeclocycline, Minocin, Tetracycline

Active trials

0

0 recruiting now

Next FDA decision

None set

FDA calendar

Medicines are those whose current FDA label names Bartonella Infection, checked October 14, 2026. Corticosteroids and immune globulins count once each. Download the data

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About Bartonella Infection

Bartonella are gram-negative bacteria that live inside cells, especially the cells lining blood vessels. More than 20 species are known, and 3 are established causes of human disease. Bartonella henselae causes cat scratch disease and spreads when a cat infected by fleas scratches or bites a person. Bartonella quintana causes trench fever and spreads through the feces of human body lice. Bartonella bacilliformis causes Carrion's disease, spread by sand flies in parts of Peru, Ecuador and Colombia, where it can cause a life-threatening fever and anemia followed by wart-like skin growths. Rarely, Bartonella has spread through organ transplants.

Whether ticks spread Bartonella is a real scientific disagreement, and it helps to know who says what. On one side, the CDC's position, updated in March 2026, is that there is no evidence Bartonella spreads to people through tick bites, and a 2010 review by Telford and Wormser, along with a 2014 review by Lantos and Wormser, concluded the case for tick transmission is unproven. On the other side, a growing body of peer-reviewed work points the other way: Bartonella henselae DNA has been found in blacklegged ticks across the eastern United States and in Ixodes ticks in Europe, a 2008 study by Cotté and colleagues showed Ixodes ricinus ticks passing live Bartonella henselae to blood meals in the laboratory, and a 2011 study by Reis and colleagues showed ticks transmitting Bartonella birtlesii to mice. Angelakis and Breitschwerdt, writing in the CDC's own journal Emerging Infectious Diseases in 2010, argued that transmission to people by ticks is plausible. Columbia University's Lyme and Tick-Borne Diseases Research Center describes the evidence for tick transmission as circumstantial but fairly strong, and the Johns Hopkins Lyme Disease Research Center lists Bartonella among the coinfections it considers in patients with Lyme disease. Physicians who follow ILADS guidelines generally treat tick transmission as likely. A fair summary is that ticks can carry Bartonella and can pass it to animals in the lab, that transmission to a person through a tick bite has not been directly documented, and that absence of proof is not proof of absence. In LymeDisease.org's 2014 survey of 3,090 people with chronic Lyme symptoms, 28% reported a Bartonella coinfection; those figures were self-reported and the sample was self-selected, so they describe the patient experience rather than measured rates.

Most cat scratch disease clears on its own within a few weeks to months. The serious forms are different: Bartonella can infect heart valves (endocarditis), which is one of the leading causes of endocarditis with negative blood cultures and needs prolonged antibiotics and sometimes valve surgery. It can also cause bacillary angiomatosis and peliosis hepatis in people with weakened immunity, and neuroretinitis (swelling of the optic nerve and retina) or encephalopathy in a small share of cat scratch cases.

Diagnosis usually combines the history (cat or kitten contact, lice, travel to the Andes) with antibody tests and, for severe or unusual cases, PCR on blood or tissue. Antibody tests can be negative early in infection and cannot always tell species apart. Specialized enrichment cultures sold by a few commercial labs can increase detection, but their results have not been validated in large independent studies. Treatment depends on the form: azithromycin for typical cat scratch disease when treatment is used at all, doxycycline plus gentamicin or rifampin for trench fever and endocarditis, and chloramphenicol or ciprofloxacin regimens for Carrion's disease. Reports of prolonged antibiotic combinations for suspected chronic Bartonella rest on case series rather than randomized trials, and claims that gene variants such as MTHFR affect treatment reactions have no supporting clinical evidence.

Common Symptoms of Bartonella Infection

Recognizing the signs of Bartonella Infection early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.

  • Prolonged low-grade fever and fatigue
  • Swollen, tender lymph nodes, usually near a cat scratch or bite
  • Bone pain and joint inflammation
  • Skin lesions including bacillary angiomatosis in immunocompromised patients
  • Neurological symptoms including headaches, cognitive difficulty, and encephalopathy
  • Heart valve inflammation (endocarditis) in severe cases

Who Bartonella Infection Affects

Can affect people of any age. Cat scratch disease is most common in children and in people who handle kittens or cats with fleas. People with weakened immune systems, including organ transplant recipients and people with HIV, are at highest risk for severe forms such as bacillary angiomatosis (blood vessel growths in the skin and organs) and peliosis hepatis (blood-filled spaces in the liver). Bartonella quintana mainly affects people with body lice, including people experiencing homelessness. Bartonella bacilliformis affects people living in or visiting the Andes mountains of South America.

Some patient surveys of people treated for chronic Lyme disease report Bartonella as a coinfection, but these are self-reported and often rest on tests that are not standardized, so the true rate is unknown.

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FDA-Approved Treatments for Bartonella Infection

There are currently 4 FDA-approved medications for Bartonella Infection. These therapies represent the current standard of care and may be used alongside or compared against investigational treatments in active clinical trials.

Demeclocycline
demeclocycline hydrochloride
Minocin
minocycline hydrochloride (immediate-release oral / iv)
Tetracycline
tetracycline hydrochloride

Source: openFDA drug labeling data. This list may not include all treatments. Always consult your doctor.

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Help Paying for Bartonella Infection Treatment

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Side Effect Explorer

Real-world side effect reports from the FDA Adverse Event Reporting System (FAERS). Includes both FDA-approved drugs and investigational therapies from active clinical trials. Click any drug to see what patients reported.

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Diagnosis and Testing

Bacterial infection (Bartonella henselae, B. quintana or B. bacilliformis); diagnosed by antibody tests or PCR, not genetics.

Trusted Bartonella Infection Resources

Reputable organizations and medical references for learning more about Bartonella Infection, including disease registries, foundation resources, and clinical guidelines.

Active Clinical Trials for Bartonella Infection

This Bartonella Infection clinical trial finder lists studies as they become available, with eligibility criteria in plain English. These studies play a critical role in advancing care for tick-borne & infectious conditions and may offer access to treatments not yet widely available. Each trial below is sourced directly from ClinicalTrials.gov, with eligibility criteria translated into plain English to help patients and caregivers evaluate whether a study may be a fit.

New to trials? What Placebos and Randomization Actually Mean for You (In Plain English) · 4 min readWorried about cost? The Hidden Costs of Joining a Clinical Trial (And How to Get Help Paying for Them) · 4 min read

Note: Trial recruitment statuses on ClinicalTrials.gov may not immediately reflect recent FDA decisions, sponsor announcements, or enrollment changes. Always confirm a trial's current status directly with the study coordinator before making plans.

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Bartonella Infection is a classified rare disease, but clinical trial activity for it is limited. That's part of why we track it. When a trial opens, Trial Friend will have it.

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Patient Communities

Connect with other Bartonella Infection patients, caregivers, and advocacy groups across Facebook groups, Reddit communities, and YouTube channels. These patient communities offer peer support, shared experiences, caregiver resources, and real-time discussion about Bartonella Infection treatments, clinical trial participation, and day-to-day disease management.

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Related Tick-Borne & Infectious Conditions

Other rare diseases in the tick-borne & infectious category. Patients with Bartonella Infection may find relevant research, shared treatment pathways, or overlapping clinical trials among these related conditions.

Frequently Asked Questions About Bartonella Infection