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J Fr Ophtalmol. 2004 Mar;27(3):285-90.
[Cat-scratch disease neuroretinitis]
Donnio A, Buestel C, Ventura E, Merle H.
Service d'Ophtalmologie, CHU, Hopital Pierre Zobda-Quitman, BP 632, 97261
Fort de France. angelique.donnio-cordoba@wanadoo.fr
We report a case of cat-scratch disease neuroretinitis for which systemic
and ocular investigations proved the responsibility of Bartonella henselae.
An 11-year-old boy was referred to the hospital in November 2002 for severe
visual loss in the left eye over the preceding 2 weeks. At the same time, he
also developed a flu-like illness. The best corrected acuity in the left eye
was counting fingers at 30 cm. Posterior segment examination on the left eye
showed an optic disk edema with papillary and peripapillary hemorrhages and
serous retinal detachment, mild vitreous inflammation, and two little
perivascular white spots.
The medical history was unremarkable except for a
cat scratch on his left forearm 2 months before. Four weeks of antibiotic
therapy including oral rifampin and doxycycline was used.
Bartonella
henselae immunoglobulin M were first detected with Bartonella henselae
immunoglobulin G testing negative at this time. A 3-week serum showed
immunoglobulin M seroreversion, while Bartonella henselae immunoglobulin G
appeared. Other causes of optic disk edema with macular star were excluded
by biological data.
Bartonella antibodies to both Bartonella henselae and
Bartonella clarridgeiae were detected in the cat. Ophthalmic follow-up
showed progressive resorption of the neuroretinitis and the visual acuity
increased to 5/10.
The significance of this case report lies in the reminder
that this pathology can be the cause of neuroretinitis; the prognosis can be
improved by earlier treatment.
PMID: 15039632 [PubMed - indexed for MEDLINE]
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