Abstract
BackgroundCat scratch disease is a systemic infectious illness caused by the bacterium Bartonella henselae. The most common ophthalmological involvement due to infection by Bartonella is Parinaud oculoglandular syndrome, whereas the most common posterior segment findings are neuroretinitis and subsequent late macular star. Moreover, other findings, such as retinal or subretinal lesions, intermediate uveitis and angiomatous lesions, may be present.Case presentationA 37-year-old female patient with retinal findings and serological confirmation of Bartonella infection was evaluated via multimodal retinal exams. The patient received treatment with doxycycline 100 mg twice daily for 2 weeks. One month after treatment, complete improvement of her visual scotoma symptoms was confirmed. A swept-source optical coherence tomography exam also showed decreases in the size and intraretinal extension of the lesion. Improvement of light perception at the affected area was confirmed by microperimetry.ConclusionsBartonella henselae infection, particularly retinitis, can present a variable spectrum of clinical and ophthalmological findings. Multimodal retinal exams can clearly identify lesion characteristics, thus providing important information for diagnosis and the evaluation of lesion improvement after antibiotic treatment.
Highlights
Cat scratch disease is a systemic infectious illness caused by the bacterium Bartonella henselae, a gram-negative bacillus responsible for a disease with a variable clinical spectrum [1,2,3]
The most common ophthalmological manifestation of Bartonella is Parinaud oculoglandular syndrome, first described in 1889, which presents as ulcerative chronic conjunctivitis and lymphadenopathy [1,2,3]
*Correspondence: paulopacr@hotmail.com Physician Department of Ophthalmology, Universidade Federal de São Paulo - EPM, Botucatu St., 821, Vila Clementino, São Paulo 04023‐062, Brazil subretinal lesions, intermediate uveitis and angiomatous lesions [3]. This case report describes a female patient with retinal findings and serologically confirmed Bartonella infection who was evaluated with multimodal retinal exams, including retinography, swept-source optical coherence tomography (SS-OCT), fundus autofluorescence (FAF), fluorescein angiography (FA), angio-OCT, and microperimetry, before and after antimicrobial treatment
Summary
Bartonella henselae infection, retinitis, can present a variable spectrum of clinical and ophthalmological findings. Multimodal retinal exams can clearly identify lesion characteristics, providing important information for diagnosis and the evaluation of lesion improvement after antibiotic treatment
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