Bartonella neuroretinitis: Case report and literature review

• Published in: Acta ophthalmologica (Oxford, England) Vol. 103; no. S284
• Main Authors: Daghouj, Ghizlane, Ettouri, Sara, Rokaya, Chahir, Rami, Ali, El Maaloum, Loubna, Allali, Bouchra, El Kettani, Asmaa
• Format: Journal Article
• Language: English
• Published: Malden Wiley Subscription Services, Inc 01.01.2025
• Subjects: Acuity; Angiography; Animal bites; Asthenia; Case reports; Cat scratch disease; Cats; Complications; Corticosteroids; Disease prevention; Edema; Eye diseases; Literature reviews; Medical imaging; Neurological complications; Prednisolone; Retina; Retinal detachment; Retinitis; Serology; Steroids; Sweating; Visual acuity; Visual perception
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/aos.17169

Aims/Purpose: The interest of this observation is to lead to think about bartonella among the etiologies of neuroretinitis Methods: We report the case of a child carrying unilateral stellar neuroretinitis in the context of cat scratch disease with a favorable evolution under treatment Results: 13‐year‐old without particular pathological history presenting a decrease in acuity with visual fog with sweating and asthenia. The initial examination found in the right eye a visual acuity at 4/10, a normal anterior segment, normal tone, and at the fundus a flat retina with stage 4 papillary edema and stellar maculopathy. The left eye was strictly normal. Faced with the notion of cat bite and scratch 5 weeks before the onset of symptomatology a bartonella serology was requested and returned positive. An angiography confirmed the fundus. An OCT highlighted a serous retinal detachment. We managed this patient with bolus of corticosteroids with a maintenance dose with prednisolone 1 mg/kg/day with adjuvant therapy. A month later visual acuity goes back to 8/10 with continuous regression of papillary edema and stellar maculopathy. The child was examinated regularly. Visual acuity at 10/10 with total regression of papillary edema and stellar maculopathy were achieved after 5 months. Angiography and OCT at this stage showed disappearance of stellar maculopathy and retinal edema with reapplication of serous retinal detachment. The degression of corticosteroid therapy has been started. Conclusions: Cat's scratch disease is an uncommon pathology. The diagnosis and management are simple but the several complications can appear including ophthalmological, visceral, neurological, osteoarticular which can engage the visual prognosis but also vital sometimes especially in immunocompromised subjects. The preventive measures for CSD would require avoidance of close contacts with cats and cat fleas with increased awareness of the risk of cats scratche. References Ocular complications of cat scratch disease | British Journal of Ophthalmology. Accessed October 30, 2022. https://bjo.bmj.com/content/104/12/1640 Whorff J. Case Report: Treatment of Severe Neuroretinitis and other Sequelae Associated with Cat Scratch Disease. Optometry and Vision Science. 2022;99(8):662‐669.