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Localised retinal vasculitis in cat scratch disease.
David Jonathan Jacobs1, Michele L Scott, M Madison Slusher
1Wake Forest Eye Center, Medical Center Blvd, Winston-Salem, North Carolina 27157, USA.
BMJ Case Reports
|June 21, 2011
Summary
An 8-year-old boy with cat scratch disease (CSD) experienced atypical ocular symptoms including retinal vasculitis. His vision improved significantly without treatment, though retinal artery inflammation persisted.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Pediatrics
Background:
- Cat scratch disease (CSD) is a bacterial infection typically caused by Bartonella henselae.
- Ocular manifestations of CSD can vary, but retinal vasculitis is uncommon.
Purpose of the Study:
- To report an unusual case of ocular CSD presenting with retinal arterial vasculitis.
- To describe the clinical course and visual outcome in a pediatric patient with this condition.
Main Methods:
- Case report of an 8-year-old male with suspected CSD.
- Clinical examination, ophthalmological assessment including funduscopy, and serological testing for Bartonella henselae antibodies.
- 18-month follow-up of visual acuity and funduscopic findings.
Main Results:
- The patient presented with localized retinal arterial vasculitis and retinal edema.
- Diagnosis of CSD was confirmed by high Bartonella henselae antibody titers and relevant history.
- Best corrected visual acuity improved from 20/30-2 to 20/25+3 in the affected eye over 18 months without intervention.
- Persistent retinal artery sheathing was noted despite visual improvement.
Conclusions:
- Ocular CSD can present atypically with retinal arterial vasculitis and edema.
- Prompt diagnosis and supportive care may lead to favorable visual outcomes in pediatric CSD.
- Long-term monitoring is essential as retinal vascular changes may persist.
