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Cat Scratch Disease: Not a Benign Condition.
Sandra Barros1, Gabriel Costa de Andrade2, Cecilia Cavalcanti2
1a Ophthalmology Department , Hospital Garcia de Orta , Almada , Portugal.
Ocular Immunology and Inflammation
|July 1, 2017
Summary
Cat-scratch disease (CSD) can cause severe vision loss, contrary to its typical benign presentation. This case series highlights vision-threatening ocular manifestations and poor outcomes, emphasizing the need for prompt diagnosis and treatment.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Bartonella henselae
Background:
- Cat-scratch disease (CSD) is typically a self-limiting infection.
- Ocular involvement in CSD can lead to significant visual impairment.
Observation:
- A retrospective case series of four patients (six eyes) with ocular CSD was analyzed.
- Patients presented with a range of visual acuities, from no light perception to 20/25.
- Two patients had bilateral ocular involvement.
Findings:
- Confirmed CSD diagnoses revealed severe, vision-threatening ocular manifestations.
- Atypical presentations included vascular angiomatous lesions, serous retinal detachment, and vascular occlusion.
- Despite treatment with antibiotics (doxycycline, clarithromycin) and corticosteroids, 5/6 eyes had final visual acuity <20/40, and 3/6 eyes had final visual acuity ≤20/400.
Implications:
- CSD can present with severe, atypical ocular findings beyond the typical presentation.
- These cases underscore the potential for guarded prognosis and significant vision loss in ocular CSD.
- Highlights the importance of considering CSD in the differential diagnosis of unexplained uveitis and retinal vascular diseases.
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