Puzzled doctors can't fathom the cause of a teen's sudden-onset schizophrenia. Numerous tests and assessments later, it turns out that it is a bad case of infection due to cat scratch.

Researchers from North Carolina State University investigate on the case of a schizophrenic teen, diagnosed with Bartonella henselae infection. The discovery is said to add to the rising evidence that such bacterium can imitate a host of long-term illnesses, such as mental diseases. This study can also pave the way for more information on how infections in general are linked to mental illnesses.

What Is Bartonella?

Bartonella is usually related with cat scratch disease, which is long thought to be a type of infection that goes away on its own after a short period. Out of the 30 species of the said bacterium, 13 are recognized to affect humans.

Bartonella is known to be very good at hiding in the coverings of blood vessels. The more experts discover this bacterium in animals and humans, the more they are able to identify it with people with long-term illnesses such as migraines and seizures. In the past, researchers are not able to link any specific causes to these chronic cases.

As molecular tests and cultures become more sensitive, experts are finding the presence of Bartonella in blood and cerebrospinal fluid samples of patients with complex neurological signs and symptoms.

A Unique Case Of Cat Scratch

The study revolves around the case of a then 14-year old boy who had a sudden onset of psychotic behavior such as delusions, hallucinations, homicidal, and suicidal thoughts.

From October 2015 to January 2017, experts ran numerous testing but were unsuccessful in identifying the underlying cause of the symptoms. The medical team also prescribed usual therapies for autoimmune and psychotic illnesses, but nothing seemed to work. Finally, in March 2017, physicians noticed scratches on the patient's skin, similar to that of Bartonella-associated infections. The boy was tested and was later found to be positive for Bartonella in the blood.

The Link Between Infections And Neuropsychiatric Disorders

The boy was diagnosed with Neurobartonellosis. The doctors then ordered treatment of antimicrobial chemotherapy with the infection as the main focus of the regimen. While such treatments were ongoing, the doctors saw improvement in the boy's neurological symptoms.

The boy underwent several blood tests and cultures in the span of his hospitalization. During those months, Bartonella levels showed a dip in number. By October 2017, all his diagnostic tests yielded negative, and he was able to return to his pre-illness state. After missing two years of school, he returned with A marks in the fall 2017 and spring 2018 semesters. By September 2018, he returned to being a student, a part-time restaurant staff and a normal teen to his peers. His parents also deemed him fully recovered at this time.

"This case is interesting for a number of reasons," says Dr. Ed Breitschwerdt, lead author and Melanie S. Steele Distinguished Professor of Internal Medicine at NC State. He adds that aside from the discovery that Bartonella could add up to progressive neuropsychiatric illnesses such as schizophrenia, it also makes experts think about the frequency of infections being linked to psychiatric disorders as a whole.

Now, scientists are beginning to investigate on things such as the link of infection to Alzheimer's. Truly, the case report opens a lot of possibilities for study, especially now that experts have proof that there are indeed connections to these medically complex disorders and infections.

The study is published in the Journal of Central Nervous System Disease.

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