Presumed diffuse unilateral subacute neuroretinitis and cat-scratch disease: Dual infection in a single patient

A healthy 35-year-old Malay woman presented with left eye pain for 1 week, and ocular examination showed evidence of panuveitis. She had granulomatous type of anterior uveitis with secondary high intraocular pressure (IOP). Fundus showed optic disc swelling, mild vitritis, and multiple subretinal lesions, which later formed a migratory track. A diagnosis of presumed diffuse unilateral subacute neuroretinitis was made. At the same time, the serology test for Bartonella henselae was positive. The patient was treated with antiglaucoma medicine and topical steroids. An antihelminthic was initially used, and later, an antibiotic for cat-scratch disease was added. In addition, focal laser photocoagulation was performed. After 3 months, her visual acuity improved together with a reduction in inflammation and well-controlled IOP.