Posterior segment involvement in cat-scratch disease: A case series.

Abstract

INTRODUCTION:

Cat-scratch disease (CSD) is a systemic infectious disease. The most well-known posterior segment presentation is neuroretinitis with a macular star. In this study, we present a case series emphasising the heterogeneity of the disease and the various posterior segment manifestations.

MATERIALS AND METHODS:

A retrospective case series of consecutive patients presenting with posterior segment CSD, over a 5-year period (2010 to 2015), at two ophthalmological centres in Midi-Pyrénées.

RESULTS:

Twelve patients (17 eyes) were included, of whom 11 (92%) presented with rapidly decreasing visual acuity, with 6 of these (50%) extremely abrupt. CSD was bilateral in 5 (42% of all patients). Posterior manifestations were: 12 instances of optic nerve edema (100%), 8 of focal chorioretinitis (67%) and only 6 of the classic macular edema with macular star (25% at first examination, but 50% later). Other ophthalmological complications developed in three patients; one developed acute anterior ischemic optic neuropathy, one a retrohyaloid hemorrhage and one a branch retinal artery occlusion, all secondary to occlusive focal vasculitis adjacent to focal chorioretinitis.

CONCLUSION:

Classical neuroretinitis with macular star is not the only clinical presentation of CSD. Practitioners should screen for Bartonella henselae in all patients with papillitis or focal chorioretinitis.

• Authors: C Tolou, L Mahieu, G Martin-Blondel, P Ollé, F Matonti, S Hamid, X Benouaich, A Debard, M Cassagne, V Soler
• Journal: Journal francais d'ophtalmologie (J Fr Ophtalmol) Vol. 38 Issue 10 Pg. 974-82 (Dec 2015) ISSN: 1773-0597 [Electronic] France
• PMID: 26545331 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Chemical References

• Adrenal Cortex Hormones
• Anti-Bacterial Agents

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Animals
• Anti-Bacterial Agents (therapeutic use)
• Cat-Scratch Disease (complications, drug therapy, epidemiology, pathology)
• Cats
• Child
• Drug Therapy, Combination
• Female
• Humans
• Macula Lutea (pathology)
• Macular Edema (etiology, pathology)
• Male
• Middle Aged
• Papilledema (etiology)
• Posterior Eye Segment (pathology)
• Retinitis (etiology)
• Retrospective Studies
• Seasons
• Visual Acuity
• Young Adult