<i>Bartonella henselae</i> Neuroretinitis in Patients without Cat Scratch

Abstract

A c c e p t e d M a n u s c r i p t 2 Bartonella henselae neuroretinitis in patients without cat scratch SUMMARY Cat-scratch disease (CSD) is a syndrome which is characterized by lymphadenopathy, fever, and skin lesions in association with a cat scratch or bite. Bartonella henselae is the primary bacterial agent responsible for CSD. Here we report serologically proven atypical presentation cases of B henselae neuroretinitis. In this study, three neuroretinitis patients were evaluated.Animal contact histories, ocular examinations, systemic work-up, clinical findings, and treatment compliance of the patients were assessed. All the patients denied a history of a cat or any animal contact, or of having CSD findings. Serologic testing with indirect immunofluorescence assay (IFA) was used for diagnosis of Bartonella neuroretinitis. IFA test results were positive for all patients. Two of the patients were treated with antibiotics. Optic disc edema and macular exudates resolved gradually, and at their last follow-up visits, all the signs had disappeared. There was no disease recurrence after finishing treatment. Serious complications were seen in the untreated patient. In conclusion, even though there may be a lack of systemic signs and symptoms of CSD in a patient with neuroretinitis, B henselae infection should be considered.

Bartonella henselae neuroretinitis in a patient without cat scratch

“…Only 2 criteria were fulfilled in our case. Celiker et al [14] reported three cases of isolated CSD neuroretinitis without contact with cats, and only 26% of patients recalled a history of cat scratch or bite in a case series of 19 patients with ocular bartonellosis [15] . This could be related to animal transmission by feces, that host Bartonella for several days and could infect man through an open wound or mucosae.…”

The Clinical Profile of Cat-Scratch Disease’s Neuro-Ophthalmological Effects

“…Neuroretinitis is described as inflammation of the optic nerve and peripapillary retina, marked by edema of the optic disc and the eventual development of a macular star. Neuroretinitis is often unilateral and might be bilateral in immunocompetent as well as immunocompromised people [ 147 ]. Ocular symptoms often manifest 2–3 weeks following the onset of systemic symptoms.…”

Is Neuroretinitis Associated With Multiple Sclerosis?

“…In my experience and that of others, cat-scratch disease is the most common infectious process associated with neuroretinitis (4,19). Neuroretinitis also can occur in association with Bartonella henselae and, less frequently, with B. quintana infections but without clinical evidence of cat-scratch disease (24). Other common infections include syphilis (25–28) and Lyme disease (29).…”