Posterior segment involvement in cat-scratch disease: A case series

Tolou, C.; Mahieu, L.; Martin‐Blondel, Guillaume; Ollé, Priscille; Matonti, F.; Hamid, S.; Benouaich, X.; Debard, Alexa; Cassagne, Myriam; Soler, V.

doi:10.1016/j.jfo.2015.07.003

Cited by 9 publications

(12 citation statements)

References 15 publications

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“…It is usually unilateral and can occur in both immunocompetent and immunocompromised patients [ 2 ]. Neuroretinitis can be observed in inflammatory diseases such as systemic erythematous lupus, Behçet disease and sarcoidosis, and most frequently in infectious diseases such as rickettsioses, Lyme disease, toxoplasmosis, tuberculosis, syphilis and cat scratch disease [ [6] , [7] , [8] ]. In CSD, neuroretinitis occurs 2–3 weeks after systemic symptoms including fever and arthromyalgia.…”

Section: Discussionmentioning

confidence: 99%

“…Other ocular manifestations include Parinaud's oculoglandular syndrome, uveitis, chorioretinitis and retinal vascular occlusion. CSD should be considered in the presence of a history of contact with cats which is reported in the majority of patients while cat scratches, licks or bites are less frequently reported [ [8] , [9] , [10] ]. The clinical features of CSD are not specific hence the need for bacteriological diagnosis which is based mainly on serologic testing by the detection of Ig G and Ig M by IFA or ELISA.…”

Section: Discussionmentioning

confidence: 99%

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Cat scratch disease neuroretinitis: A case report

Mahjoub

Bellazreg

Abdesslem

et al. 2021

Annals of Medicine &Amp; Surgery

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Introduction Cat scratch disease (CSD) is a ubiquitous infectious disease caused by a Gram-negative intracellular bacillus, Bartonella henselae. Neuroretinitis is a classical but rare manifestation of CSD. Case presentation A 20-year-old woman presented with a 5-day-history of reduced vision in the left eye (LE). Two weeks before eye symptoms, she complained from fever, fatigue and arthromyalgia which resolved spontaneously. In the LE, visual acuity (VA) was 7/10, fundus photography showed optic disc edema with macular exudates arranged in incomplete macular star. Serologic test for Bartonella henselae using indirect immunofluorescent assay (IFA) was highly positive (1:2560 UI/L) for immunoglobulin G (Ig G). The diagnosis of CSD associated neuroretinitis has been made and the patient was treated with doxycycline, rifampicin and oral prednisolone. Twelve months after the end of therapy, VA was 10/10, fundus photography and Macular OCT were normal. Discussion In CSD, neuroretinitis occurs 2–3 weeks after systemic symptoms. The clinical features of CSD are not specific hence the need for bacteriological diagnosis which is based mainly on serologic testing by the detection of Ig G and Ig M by IFA or ELISA. The treatment of CSD-associated neuroretinitis is not standardized. Antibiotics active against intracellular bacteria, with or without systemic corticosteroids, should be prescribed especially in severe cases. The outcome of Bartonella henslae neuroretinitis is usually favourable. Conclusion Despite rarely reported in Tunisia, CSD should be considered in patients with presence of typical neuroretinitis with macular star and of a history of contact with cats.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cat scratch disease neuroretinitis: A case report

Mahjoub

Bellazreg

Abdesslem

et al. 2021

Annals of Medicine &Amp; Surgery

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“…The lymphadenitis in CSD often resolves spontaneously within 3 months. Antibiotics are not indicated in the majority of cases, but they may be considered for severe or systemic disease involving the bone marrow, liver, spleen, brain and eyes ( 31 – 35 ), particularly in immunocompromised patients. A total of 10–35% of the infected nodes progress to suppuration, and evacuating the pus is necessary in this condition ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

Lymphadenitis associated with cat‑scratch disease simulating a neoplasm: Imaging findings with histopathological associations

Chen

et al. 2017

Oncol Lett

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The lymphadenitis associated with cat-scratch disease (CSD) is often confused with neoplasms by a number of radiologists and clinicians, and consequently, unnecessary invasive procedures or surgeries are performed. In the present study, the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) findings of 10 patients (6 men and 4 women) with clinically and pathologically confirmed lymphadenitis associated with CSD were retrospectively analyzed (CT in 3 patients, MRI in 6 patients, and CT and MRI in 1 patient) at The Second Affiliated Hospital of Zhejiang University School of Medicine (Hangzhou, China) between January 2007 and November 2014. As a result, 17 enlarged lymph nodes were identified in 10 cases. The 5 nodes identified by CT scan exhibited relatively inhomogeneous isodensity to muscle, with patchy low density in the center. All 14 nodes identified by MRI scan exhibited homogeneous or heterogeneous isointensity to muscle or slightly increased intensity compared with that of muscle on T1-weighted images (T1WI), and homogeneous or heterogeneous hyperintensity on fat-suppressed T2WI. Following enhancement, all 17 enlarged lymph nodes associated with CSD demonstrated the following 3 different enhancement patterns: Moderate homogeneous enhancement (n=8), which was associated with histologically identified early disease stage; marked heterogeneous enhancement with no enhancement of the necrotic areas (n=4), and heterogeneous enhancement with progressively ‘spoke-wheel-like’ (defined as radiating enhancement from the center) enhancement of the patchy low-density area (n=1), which was associated with histologically identified intermediate disease stage; and astral low-density/hypointensity with marked enhancement (n=2) or a ‘rose flower’ sign (n=2), which was associated with histologically identified late disease stage. We hypothesized that the CT and MRI results of lymphadenitis in CSD may be associated with the pathological features. It may be suggested that the diagnosis of CSD may be formed when considering the characteristic CT and MRI features of astral low-density/hypointensity with marked enhancement or a ‘rose flower’ sign (defined as marginal petaloid enhancement) in the late disease stage, or the MRI results of homogeneous, moderate enhancement in the early disease stage, or the CT/MRI data of heterogeneous enhancement with non-enhancing area in the center in the intermediate disease stage, in solitary or multiple enlarged lymph nodes associated with general subcutaneous edema in the vicinity of the nodes on CT/MRI and with a history of cat exposure.

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“…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].…”

Section: Introductionmentioning

confidence: 99%

“…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]. The most common posterior segment findings are a swollen optic disc, neuroretinitis and subsequent late macular star [1,4], but other findings may be present, such as retinal or subretinal lesions, intermediate uveitis and angiomatous lesions [3].…”

Section: Introductionmentioning

confidence: 99%

Bartonella hanselae retinitis patient evaluated with multimodal retinal exams

et al. 2020

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Background Cat 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 presentation A 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. Conclusions Bartonella 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.

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Posterior segment involvement in cat-scratch disease: A case series

Cited by 9 publications

References 15 publications

Cat scratch disease neuroretinitis: A case report

Cat scratch disease neuroretinitis: A case report

Lymphadenitis associated with cat‑scratch disease simulating a neoplasm: Imaging findings with histopathological associations

Bartonella hanselae retinitis patient evaluated with multimodal retinal exams

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