Madison Area Lyme Support Group

PURPOSE:

To report two cases of cat-scratch fever with atypical posterior segment manifestations.

METHODS:

Two cases were retrospectively reviewed.

RESULTS:

• A 27-year-old woman presented with painless blurring of central vision in her left eye. Clinical examination revealed a small focal area of retinitis within the macula associated with a subtle macular star. Spectral-domain optical coherence tomography showed a hyper-reflective inner retinal lesion in addition to subretinal and intraretinal fluid as well as hyperreflective foci within the outer plexiform layer. Serology was positive for anti-B. henselae IgM (titer 1:32).
• A 34-year-old woman presented with painless loss of vision in both eyes associated with headaches and pain with extraocular movement. Spectral-domain optical coherence tomography depicted subretinal fluid, intraretinal fluid, and hyperreflective deposits within the outer plexiform layer. A focal collection of vitreous cell was observed overlying the optic nerve in the left eye. Bilateral disk leakage was identified on fluorescein angiography. Serology revealed high-titer anti-B. henselae antibodies (IgM titers 1:32, IgG titers 1:256).

CONCLUSION:

Our cases highlight the necessity of recognizing more unusual posterior segment presentations of ocular bartonellosis. Multimodal retinal imaging including spectral-domain optical coherence tomography may help better characterize lesions.

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For more:  https://madisonarealymesupportgroup.com/2019/07/28/treatment-strategies-for-neuroretinitis-due-to-bartonella-current-options-emerging-therapies/

https://madisonarealymesupportgroup.com/2018/07/10/bartonella-henselae-neuroretinitis-in-patients-without-cat-scratch/

https://madisonarealymesupportgroup.com/2017/07/21/bartonella-and-neuroretinitis/

https://madisonarealymesupportgroup.com/2018/05/10/bartonella-neuroretinitis-not-atypical/

https://madisonarealymesupportgroup.com/2019/04/08/case-series-bartonella-ocular-manifestations/

https://madisonarealymesupportgroup.com/2019/02/27/advanced-imaging-found-bartonella-around-pic-line/  Bartonella, like Lyme, can be persistent causing chronic infection.