2013 - 1 Issue

Case report

Bilateral Neuroretinitis as an Ocular Manifestation of Cat Scratch Disease in a 9-year-old Boy

Denisa Petrušková
Pavel Pochop – Martina Kodetová – Barbora Obermannová – Dagmar Dotřelová

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Published in Czech and Slovak Ophtalmology: 2013 - 1

Published on website: 25.02.2013

Keywords: cat scratch disease, bilateral stellate maculopathy, neuroretinitis, boy

Summary

Purpose: 1. To highlight a less-known clinical entity neuroretinitis and the need for differentiation of this entity from the other retinal disease that can mimic. 2. To be familiar with ocular finding in Cat scratch disease.
Material and methods: Case report. Authors describe a clinical course of bilateral neuroretinitis in a 9-year-old boy who was referred to our clinic with painless decreased corrected visual aquity in the right eye (6/18) and in the left eye (6/9). Fundus examination disclosed bilateral stellate maculopathy. Patient had a history of close contact with a cat. Serologic tests for infective disease confirmed the presence of IgG antibody against Bartonella henselae (1:64). Specific antibiotic treatment with bacteriostatical activity against Bartonella henselae restored functional and anatomical changes in both of eyes within two month.
Results: Noninfective etiology of bilateral neuroretinitis was essential to exclude in differential diagnosis. Diagnosis of Cat scratch disease was based on positive epidemiological diagnosis, bilateral manifestation of neuroretinitis, high IgG antibody titre against Bartonella henselae and successful treatment of this disease after specific antibiotic therapy.
Conclusion: Neuroretinitis is the most common ocular manifestation of cat scratch disease. Familiarity with differential diagnosis of neuroretinitis is essential for prompt causal treatment initialisation.

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