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International Ophthalmology

, Volume 31, Issue 2, pp 125–128 | Cite as

Unusual retinal manifestations of cat scratch disease

  • Antonio Pinna
  • Ester Puglia
  • Stefano Dore
Case Report

Abstract

We report on 2 patients with unusual retinal manifestations of cat scratch disease (CSD), caused by Bartonella henselae. Case 1. A 42-year-old farmer presented with a 5-day history of blurred vision in his right eye. Right visual acuity was 20/25. Fundus examination of the right eye revealed mild vitreous hemorrhage and diffuse retinal hemorrhages in the mid-peripheral retina. Fluorescein angiography showed multiple vasculitic occlusions in the same area. A blood sample taken on the day of examination revealed the presence of immunoglobulin (Ig)M and IgG to B. henselae. Oral azithromycin was given for 8 days. One month later, right visual acuity was 20/20, the vitreous and retinal hemorrhages resolved, and arteriolar attenuation and sclerosis was observed in the peripheral temporal retina. Case 2. A 66-year-old craftsman with systemic hypertension and hypercholesterolemia complained of sudden visual loss (light perception) in his left eye. Fundus evaluation and fluorescein angiography revealed central retinal artery occlusion (CRAO) in the affected eye. About 2 weeks earlier, he had been bitten and scratched on his right hand by a stray cat. Serologic testing detected the presence of IgM to B. henselae. Oral azithromycin was given for 6 days. One month later, left visual acuity was hand motion. Ophthalmologists should be aware that unusual ocular complications associated with CSD include vitreous hemorrhage with retinal vasculitis and isolated CRAO. Vitreous hemorrhage and retinal vasculitis may be the only clinical manifestation of CSD.

Keywords

Bartonella henselae Cat scratch disease Central retinal artery occlusion Indirect immunofluorescence Retinal vasculitis Vitreous hemorrhage 

Notes

Conflict of interest

None

References

  1. 1.
    Ormerod LD, Dailey JP (1999) Ocular manifestations of cat-scratch disease. Curr Opin Ophthalmol 10:209–216PubMedCrossRefGoogle Scholar
  2. 2.
    Cunningham ET, Koehler JE (2000) Ocular bartonellosis. Am J Ophthalmol 130:340–349PubMedCrossRefGoogle Scholar
  3. 3.
    Roe RH, Jumper JM, Fu AD, Johnson RN, McDonald HR, Cunningham ET (2008) Ocular bartonella infections. Int Ophthalmol Clin 48:93–105PubMedCrossRefGoogle Scholar
  4. 4.
    Anderson BE, Neuman MA (1997) Bartonella spp. as emerging human pathogens. Clin Microbiol Rev 10:203–219PubMedGoogle Scholar
  5. 5.
    Carithers HA (1985) Cat-scratch disease. an overview based on a study of 1, 200 patients. Am J Dis Child 139:1124–1133PubMedGoogle Scholar
  6. 6.
    Ormerod LD, Skolnick KA, Menosky MM, Pavan PR, Pon DM (1998) Retinal and choroidal manifestations of cat-scratch disease. Ophthalmology 105:1024–1031PubMedCrossRefGoogle Scholar
  7. 7.
    Solley WA, Martin DF, Newman NJ et al (1999) Cat scratch disease: posterior segment manifestations. Ophthalmology 106:1546–1553PubMedCrossRefGoogle Scholar
  8. 8.
    Soheilian M, Markomichelakis N, Foster CS (1996) Intermediate uveitis and retinal vasculitis as manifestations of cat scratch disease. Am J Ophthalmol 122:582–584PubMedGoogle Scholar
  9. 9.
    Gray AV, Michels KS, Lauer AK, Samples JR (2004) Bartonella henselae infection associated with neuroretinitis, central retinal artery and vein occlusion, neovascular glaucoma, and severe vision loss. Am J Ophthalmol 137:187–189PubMedCrossRefGoogle Scholar
  10. 10.
    Berguiga M, Abouzeid H, Bart PA, Guex-Crosier Y (2008) Severe occlusive vasculitis as a complication of cat scratch disease. Klin Monatsbl Augenheilkd 225:486–487PubMedCrossRefGoogle Scholar
  11. 11.
    Dörbecker C, Sander A, Oberle K, Schülin-Casonato T (2006) In vitro susceptibility of Bartonella species to 17 antimicrobial compounds: comparison of Etest and agar dilution. J Antimicrob Chemother 58:784–788PubMedCrossRefGoogle Scholar
  12. 12.
    Kirby JE (2004) In vitro model of Bartonella henselae-induced angiogenesis. Infect Immun 72:7315–7317PubMedCrossRefGoogle Scholar
  13. 13.
    Curi AL, Machado DO, Heringer G, Campos WR, Orefice F (2006) Ocular manifestation of cat-scratch disease in HIV-positive patients. Am J Ophthalmol 141:400–401PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.Institute of OphthalmologyUniversity of SassariSassariItaly
  2. 2.Department of OphthalmologyBinaghi HospitalCagliariItaly

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