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Neuroretinitis in cat scratch disease: a case report

Luka Jerković orcid.org/0000-0002-7261-2722 ; Opća bolnica Karlovac, Karlovac
Vlatka Lovraković Polak ; Opća bolnica Karlovac, Karlovac
Ivana Bednar Babić ; Opća bolnica Karlovac, Karlovac
Vesna Tutek ; Opća bolnica Karlovac, Karlovac

Abstract

A 21-year-old, previously healthy woman presented to our hospital with a sudden loss of vision to the right eye two days before admission. A two-week febrile period preceeded the vision loss. At the time of the admission the patient had decreased visual acuity in the right eye with otherwise normal general health status. Ophtalmological exam discovered unilateral blurred optic disc margins with disc swelling. On the second day it progressed and became billateral optic disc oedema with the development of the macular star formation which is tipical in the diagnosis of neuroretinitis. An infectologist was consulted, extensive laboratory workup was performed that also included serological tests. The patient was treated with antimicrobial therapy, corticosteroids and gastroprotectants. At the begining, the patient experienced a decrease in visual acuity, but later in the course of disease, her vision gradually recovered. Serological testing confirmed Bartonella henselae as the main etiological factor. Over the next six weeks she was treated with doxycycline and rifampicin. During the ambulatory follow up, visual acuity of the left eye completely restored, but visual acuity of the right eye, which was first affected, even after complete resolution of the optic disc oedema, hasn`t recovered fully to the level before the begining of the disease.

Keywords

neuroretinitis; indirect immunofluorescence assay (IFA); corticosteroids; doxycycline; rifampicin

Hrčak ID:

204602

URI

https://hrcak.srce.hr/204602

Publication date:

30.7.2018.

Article data in other languages: croatian

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