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Neuroretinitis caused by Bartonella henselae in Gipuzkoa, 2014-2019
Yolanda Salicio-Bermejo1, Gustavo Cilla-Eguiluz2, Ana Blanco-Esteban3
1Servicio de Microbiología, Hospital Universitario Donostia, Organización Sanitaria Integrada Donostialdea, San Sebastián, Gipuzkoa, España.
Insights
Bartonella henselae can cause severe eye complications like optic neuritis and neuroretinitis in cat scratch disease (CSD) patients. Early diagnosis and considering CSD are crucial for patients with sudden vision loss and cat exposure.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Veterinary Medicine
Background:
- Bartonella henselae is the causative agent of cat scratch disease (CSD).
- Cats serve as the primary reservoir for B. henselae.
- CSD can lead to ocular complications, including optic neuritis and neuroretinitis.
Purpose of the Study:
- To review the incidence and characteristics of optic neuritis and neuroretinitis associated with B. henselae in Gipuzkoa, Spain.
- To analyze cases of CSD with ocular manifestations between 2014 and 2019.
Main Methods:
- Retrospective review of clinical records and serological data.
- Inclusion criteria: consistent clinical signs of CSD, history of cat contact, and positive B. henselae serology (IgG-IFA ≥ 1/256).
Main Results:
- Sixty-four patients were diagnosed with CSD.
- Ocular complications (optic neuritis or neuroretinitis) occurred in 4 patients (6.3%).
- Two patients experienced persistent vision loss despite treatment.
Conclusions:
- B. henselae-induced optic neuritis and neuroretinitis are significant complications of CSD.
- A non-negligible incidence of these ocular conditions was observed in the study region.
- Clinicians should consider CSD in patients presenting with optic neuritis or neuroretinitis, especially with a history of cat contact.
Introduction:
Bartonella henselae causes cat scratch disease (CSD), spread by a cat scratch or bite. Cats are its main reservoir. This sometimes results in optic neuritis or neuroretinitis.
Objective:
To review these conditions in Gipuzkoa (Spain), 2014-2019.
Methods:
A retrospective review of serology and clinical records, selecting those with consistent clinical signs, contact with cats and positive serology for B. henselae (IgG-IFA≥1/256).
Results:
Sixty-four patients had CSD. Of these, one had optic neuritis and 3 had neuroretinitis (4/64; 6.3%). In 3 patients, flu-like symptoms preceded eye symptoms. Two suffered from loss of visual acuity at discharge, despite prolonged treatment with antibiotics and corticosteroids.
Conclusion:
Optic neuritis and neuroretinitis caused by B. henselae are severe complications with a non-negligible incidence among patients with CSD in Gipuzkoa. We recommend ruling out CSD in patients with symptoms of optic neuritis or neuroretinitis (sudden vision loss, etc.) and contact with cats.
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