Case Series of Neuroretinitis in Cat Scratch Disease
Main Article Content
Abstract
Introduction: Neuroretinitis is a typical ocular presentation of cat scratch disease (CSD). It is characterised by optic disc swelling with macular star formation. Bartonella henselae is the commonest cause of neuroretinitis. Case series: This article provides a retrospective review of the variations in three patients’ clinical presentations and responses to the two of the treatment options available for the disease. We report a retrospective case series of neuroretinitis in CSD with three patients who presented to the ophthalmology clinic at Selayang Hospital from June 2016 to August 2019. All patients had a history of contact with cats with two of them had a history of fever before developing ocular symptoms. All patients presented with optic disc swelling and macular star. In addition, Case 2 presented with mild vitritis and Case 3 with multiple foci of choroiditis. A serology analysis of Bartonella henselae was positive for both immunoglobulin (Ig) M and IgG in all three patients. Two of the patients were treated with oral doxycycline, while Case 3 was treated with oral sulfamethoxazole and trimethoprim. All patients had a poor vision at their initial presentation, but none of them warranted oral prednisolone and had good visual outcomes. Conclusion: Neuroretinitis is a typical ocular presentation of CSD. Diagnosis is confirmed via positive serologic testing for Bartonella henselae. Although neuroretinitis is self-limiting, various treatment options can hasten disease recovery with good visual outcomes.
Downloads
Article Details
References
Biancardi AL, Curi ALL. Cat-scratch disease. Ocul Immunol Inflamm. 2014 Apr;22(2):148–54.
Cunningham ET, Koehler JE. Ocular bartonellosis. Am J Ophthalmol. 2000 Sep;130(3):340–9.
Nelson CA, Saha S, Mead PS. Cat-Scratch Disease in the United States, 2005-2013. Emerg Infect Dis. 2016 Oct;22(10):1741–6.
Bhengsri S, Baggett HC, Peruski LF, Morway C, Bai Y, Fisk TL, et al. Bartonella seroprevalence in rural Thailand. Southeast Asian J Trop Med Public Health. 2011 May;42(3):687–92.
Sander A, Posselt M, Oberle K, Bredt W. Seroprevalence of antibodies to Bartonella henselae in patients with cat scratch disease and in healthy controls: evaluation and comparison of two commercial serological tests. Clin Diagn Lab Immunol. 1998 Jul;5(4):486–90.
Sun J, Fu G, Lin J, Song X, Lu L, Liu Q. Seroprevalence of Bartonella in Eastern China and analysis of risk factors. BMC Infect Dis. 2010 May 20;10:121.
Domínguez I, Cartes C, Sabat P, Ortiz O, Matus G, Traipe L. Isolated conjunctival granuloma as a first manifestation of Parinaud’s oculoglandular syndrome: A case report. Am J Ophthalmol Case Rep. 2019 Jun;14:58–60.
Huwyler C, Heiniger N, Chomel BB, Kim M, Kasten RW, Koehler JE. Dynamics of Co-Infection with Bartonella henselae Genotypes I and II in Naturally Infected Cats: Implications for Feline Vaccine Development. Microb Ecol. 2017 Aug;74(2):474–84.
Habot-Wilner Z, Trivizki O, Goldstein M, Kesler A, Shulman S, Horowitz J, et al. Cat-scratch disease: ocular manifestations and treatment outcome. Acta Ophthalmol. 2018 Mar 5;96(4):524–32.
Rolain JM, Brouqui P, Koehler JE, Maguina C, Dolan MJ, Raoult D. Recommendations for treatment of human infections caused by Bartonella species. Antimicrob Agents Chemother. 2004 Jun;48(6):1921–33.
Chi SL, Stinnett S, Eggenberger E, Foroozan R, Golnik K, Lee MS, et al. Clinical characteristics in 53 patients with cat scratch optic neuropathy. Ophthalmology. 2012 Jan;119(1):183–7.
Zacchei AC, Newman NJ, Sternberg P. Serous retinal detachment of the macula associated with cat scratch disease. Am J Ophthalmol. 1995 Dec;120(6):796–7.
Hanifatiyah Ali, Mohd Fairuz Ali, Nor Azita Ahmad Tarmidzi, Raja Nor Farahiyah Raja Othman. Altered vision in MSM patient, diagnosis of ocular syphilis in primary care: a case report. Mal J Med Health Sci. 2019;15(1):85–8.
Purvin VA. Optic neuropathies for the neurologist. Semin Neurol. 2000;20(1):97–110.
Cruz FM, Arcinue CA. A Review Article on Neuroretinitis. Philipp J Ophthalmol. 2018; 42(1):3-9
Ksiaa I, Abroug N, Mahmoud A, Zina S, Hedayatfar A, Attia S, et al. Update on Bartonella neuroretinitis. J Curr Ophthalmol. 2019 Sep;31(3):254–61.
Metzkor-Cotter E, Kletter Y, Avidor B, Varon M, Golan Y, Ephros M, et al. Long-term serological analysis and clinical follow-up of patients with cat scratch disease. Clin Infect Dis. 2003 Nov 1;37(9):1149–54.
Reed JB, Scales DK, Wong MT, Lattuada CP Jr, Dolan MJ, Schwab IR. Bartonella henselae neuroretinitis in cat scratch disease. Diagnosis, management, and sequelae. Ophthalmology. 1998 Mar;105(3):459–66.
Klotz SA, Ianas V, Elliott SP. Cat-scratch Disease. Am Fam Physician. 2011 Jan 15;83(2):152–5.
Tey MS-Y, Govindasamy G, Vendargon FM. The clinical spectrum of ocular bartonellosis: a retrospective study at a tertiary centre in Malaysia. J Ophthalmic Inflamm Infect. 2020 Nov 16;10(1):31.