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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, Spain.
Insights
Bartonella henselae (CSD) can cause severe eye conditions like optic neuritis and neuroretinitis. Early CSD diagnosis in patients with eye symptoms and cat contact is crucial for timely treatment.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Bartonella henselae is the causative agent of cat scratch disease (CSD).
- CSD is transmitted through cat scratches or bites, with cats as the primary reservoir.
- Ocular complications, including optic neuritis and neuroretinitis, can occur in CSD patients.
Purpose of the Study:
- To review the incidence and characteristics of optic neuritis and neuroretinitis associated with CSD in Gipuzkoa, Spain.
- To assess the clinical presentation and outcomes of these ocular complications.
Main Methods:
- Retrospective review of serology and clinical registries from 2014 to 2019.
- Inclusion criteria: consistent clinical signs of CSD, history of cat contact, and positive serology for Bartonella henselae (IgG-IFA ≥1/256).
- Selection of patients diagnosed with optic neuritis or neuroretinitis.
Main Results:
- Sixty-four patients were diagnosed with CSD.
- Four patients (6.3%) presented with ocular complications: one with optic neuritis and three with neuroretinitis.
- Some patients experienced preceding flu-like symptoms and persistent vision loss despite treatment.
Conclusions:
- Optic neuritis and neuroretinitis are significant, non-negligible complications of CSD in the Gipuzkoa region.
- Bartonella henselae should be considered in the differential diagnosis of patients presenting with optic neuritis or neuroretinitis, especially those with a history of cat contact.
- Prompt diagnosis and management of CSD are important to prevent severe visual impairment.
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 registries and clinical registries, 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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