Neuroretinitis with dual infections.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Neuroscience

Background:

• Ocular manifestations of Bartonella henselae infection can be diverse.
• Diffuse unilateral subacute neuroretinitis (DUSN) is a rare inflammatory condition affecting the optic nerve and retina.

Observation:

• A 22-year-old female presented with decreased vision, visual field defects, and metamorphopsia in her left eye.
• Fundus examination revealed optic disc swelling, macular star, and characteristic migratory choroidal lesions.
• Serological testing confirmed Bartonella henselae infection.

Findings:

• The patient was diagnosed with a dual infection: DUSN and cat scratch disease (CSD).
• Treatment involved oral albendazole for DUSN and doxycycline for CSD, along with focal laser photocoagulation.
• The patient experienced significant visual recovery and resolution of retinal inflammation within one month.

Implications:

• This case highlights the importance of considering dual infections in patients with neuroretinitis.
• Early diagnosis and combined treatment are crucial for favorable visual outcomes in DUSN and CSD.
• Bartonella henselae should be considered in the differential diagnosis of unexplained neuroretinitis, even without a history of cat exposure.