Paediatria Croatica, Vol. 62 No. 3, 2018.
Professional paper
https://doi.org/10.13112/PC.2018.18
Neuroretinitis caused by Bartonella henselae: case report
Sofia Simoes Ferreira
; Paediatrics Department, Centro Hospitalar de
Andreaia Ribeiro
Filipe Neves
Isabel Pinto Pais
Teresa Torres
Dalia Meira
Marta Vila Real
Abstract
Cat scratch disease is an infectious disease caused by Bartonella henselae characterized by regional lymphadenopathy and fever.
Although it may involve other organs, ocular involvement is rare (5%-10%) and may manifest as neuroretinitis. We present a case of
an 11-year-old patient admitted to the emergency department because of vision loss on the right eye, detected on a vision screening
test. Ophthalmological evaluation showed disc swelling, peripapillary microhaemorrhages and macular oedema with lipid-rich
exudates, suggestive of the macular star pattern. Serological studies revealed elevated titre of antibodies to Bartonella henselae. The
patient was treated with rifampicin and doxycycline, with optimal response. Neuroretinitis is an uncommon manifestation of
Bartonella henselae infection and should be suspected in any patient presenting loss of visual acuity, along with the fi nding of disc
swelling, macular star exudates, and a history of contact with cats. Most patients recover most or all of their pre-infection visual function,
however, a small subset of patients with particularly severe neuroretinitis may be left with optic sequelae. There are no randomized
trials on the eff ectiveness of treatment but antibiotic therapy with rifampicin and doxycycline seems to shorten the course of the
disease and hasten visual recovery.
Keywords
BARTONELLA HENSELAE; CAT SCRATCH DISEASE; RETINITIS; PAEDIATRICS; VISUAL ACUITY; OPTIC DISC
Hrčak ID:
216973
URI
Publication date:
25.9.2018.
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