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."