Medical Subject Headings

Cat-Scratch Disease; Bartonella henselae; Bartonella quintana; Papilledema; Vision, Monocular; Retinitis; Immunoglobulin G


Background: Neuroretinitis is a self-limiting condition which typically causes monocular vision loss with good potential for visual recovery. It may be idiopathic or associated with infectious or inflammatory conditions which can carry systemic implications. Neuroretinitis classically presents with disc edema followed by development of a macular star pattern of exudates. It is most commonly attributed to Cat Scratch Disease, or Bartonella henselae infection. However, there have been few published reports of Bartonella quintana associated neuroretinitis.

Case Report: A 60-year-old patient presented with unilateral vision loss preceded by flu-like illness. The patient had exposure to a recently adopted cat. Fundus examination revealed a stellate pattern of exudates in the macula of the affected eye with questionable sectoral optic disc edema. Serologic testing revealed a positive titer for Bartonella quintana IgG antibody, but negative Bartonella henselae testing. This report highlights a rare case of neuroretinitis related to B. quintana infection.

Conclusion: While neuroretinitis is generally considered to be self-limiting, it may be related to a systemic infection, such as B. henselae and B. quintana. Both B. henselae and B. quintana may present with ocular findings in the setting of nonspecific systemic symptoms. A thorough ophthalmic examination and history in conjunction with serologic testing can help to establish a diagnosis and prompt consideration of further testing or treatment for concurrent systemic disease.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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