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Severe occlusive vasculitis as a complication of cat scratch disease
M Berguiga1, H Abouzeid, P-A Bart
1Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland.
Background:
The purpose of this communication is to report a severe occlusive vasculitis as a complication of cat scratch.
History And Signs:
A 34-year-old Hispanic woman presented with a sudden visual loss of the right eye associated with shivers, high fever and arthritis which developed 2 months after a cat's bite. Fundus examination showed papillitis and a palor of the paramacular zone of the retina. Fluorescein angiography revealed multiple arterial and venous vasculitic occlusions.
Therapy And Outcome:
Auto-immune disease and endocarditis were ruled out by an extensive medical work-up. The diagnosis of Bartonella henselae was confirmed by a positive serology. A systemic antibiotherapy with azithromycin, doxycyclin, rifampicin and steroid therapy resulted in a good clinical response, including a rapid visual recovery with a visual acuity of 20/20 and no relapse of the disease at 6 months follow-up.
Conclusions:
Ocular complications associated with cat scratch disease may include vasculitis with both arterial and venous occlusions causing severe visual loss.
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