Infection

, Volume 40, Issue 2, pp 191–194 | Cite as

Bilateral Bartonella henselae neuroretinitis with stellate maculopathy in a 6-year-old boy

Case Report

Abstract

Purpose

Bartonella henselae, the cause of cat-scratch disease in humans, may lead to characteristic vision-threatening ocular findings, which importantly indicate diagnosis.

Methods

This is an observational case report of a 6-year-old boy who presented with bilateral stellate maculopathy and lymphadenopathy.

Results

After serologic verification of B. henselae infection, systemic azithromycin therapy initiated the full recovery of visual acuity and bilateral complete resolution of stellate exudates during the following months.

Conclusion

Stellate maculopathy should always include the differential diagnosis of B. henselae infection. In this rare case of bilateral stellate maculopathy, we observed full recovery of function following systemic macrolide therapy.

Keywords

Macular star Bartonella henselae Infection Ocular 

References

  1. 1.
    Florin TA, Zaoutis TE, Zaoutis LB. Beyond cat scratch disease: widening spectrum of Bartonella henselae infection. Pediatrics. 2008;121:e1413–25. doi:10.1542/peds.2007-1897.PubMedCrossRefGoogle Scholar
  2. 2.
    Boulouis HJ, Chang CC, Henn JB, Kasten RW, Chomel BB. Factors associated with the rapid emergence of zoonotic Bartonella infections. Vet Res. 2005;36:383–410. doi:10.1051/vetres:2005009.PubMedCrossRefGoogle Scholar
  3. 3.
    Durá-Travé T, Yoldi-Petri ME, Gallinas-Victoriano F, Lavilla-Oiz A, Bove-Guri M. Neuroretinitis caused by Bartonella henselae (cat-scratch disease) in a 13-year-old girl. Int J Pediatr. 2010;2010:763105. doi:10.1155/2010/763105.PubMedGoogle Scholar
  4. 4.
    Cunningham ET, Koehler JE. Ocular bartonellosis. Am J Ophthalmol. 2000;130:340–9. doi:S0002939400005730.PubMedCrossRefGoogle Scholar
  5. 5.
    Pandak N, Daković-Rode O, Cabraja I, Kristof Z, Kotarac S. Prevalence of Bartonella henselae antibodies in children and blood donors in Croatia. Infection. 2009;37:166–7. doi:10.1007/s15010-008-8113-0.PubMedCrossRefGoogle Scholar
  6. 6.
    Sweeney VP, Drance SM. Optic neuritis and compressive neuropathy associated with cat scratch disease. Can Med Assoc J. 1970;103:1380–1.PubMedGoogle Scholar
  7. 7.
    Zangwill KM, Hamilton DH, Perkins BA, Regnery RL, Plikaytis BD, Hadler JL, Cartter ML, Wenger JD. Cat scratch disease in Connecticut. Epidemiology, risk factors, and evaluation of a new diagnostic test. N Engl J Med. 1993;329:8–13. doi:10.1056/NEJM199307013290102.PubMedCrossRefGoogle Scholar
  8. 8.
    Ormerod LD, Dailey JP. Ocular manifestations of cat-scratch disease. Curr Opin Ophthalmol. 1999;10:209–16.PubMedCrossRefGoogle Scholar
  9. 9.
    Wade NK, Levi L, Jones MR, Bhisitkul R, Fine L, Cunningham ET Jr. Optic disk edema associated with peripapillary serous retinal detachment: an early sign of systemic Bartonella henselae infection. Am J Ophthalmol. 2000;130:327–34. doi:S0002939400005997.PubMedCrossRefGoogle Scholar
  10. 10.
    Reed JB, Scales DK, Wong MT, Lattuada CP Jr, Dolan MJ, Schwab IR. Bartonella henselae neuroretinitis in cat scratch disease. Diagnosis, management, and sequelae. Ophthalmology. 1998;105:459–66. doi:10.1016/S0161-6420(98)93028-7.PubMedCrossRefGoogle Scholar
  11. 11.
    Suhler EB, Lauer AK, Rosenbaum JT. Prevalence of serologic evidence of cat scratch disease in patients with neuroretinitis. Ophthalmology. 2000;107:871–6. doi:10.1016/S0161-6420(00)00002-6.PubMedCrossRefGoogle Scholar
  12. 12.
    Golnik KC, Marotto ME, Fanous MM, Heitter D, King LP, Halpern JI, Holley PH Jr. Ophthalmic manifestations of Rochalimaea species. Am J Ophthalmol. 1994;118:145–51.PubMedGoogle Scholar
  13. 13.
    Wade NK, Po S, Wong IG, Cunningham ET Jr. Bilateral Bartonella-associated neuroretinitis. Retina. 1999;19:355–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Besson-Leaud L, Mancel E, Missotte I, Morlat C, Menager C. Sudden sight impairment revealing a cat-scratch disease: report of three cases. Arch Pediatr. 2004;11:1209–11. doi:10.1016/j.arcped.2004.06.025.PubMedCrossRefGoogle Scholar
  15. 15.
    Hernandez-Da-Mota S, Escalante-Razo F. Bartonellosis causing bilateral Leber neuroretinitis: a case report. Eur J Ophthalmol. 2009;19:307–9.PubMedGoogle Scholar
  16. 16.
    Ramharter A, Kremser B. Bilateral panuveitis with serous retinal detachment. Ophthalmologe. 2009;106:351–5. doi:10.1007/s00347-008-1807-y.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • C. H. D. Metz
    • 1
  • J. Buer
    • 2
  • N. Bornfeld
    • 1
  • A. Lipski
    • 1
  1. 1.Eye Clinic, Center for OphthalmologyUniversity of Duisburg-EssenEssenGermany
  2. 2.Institute of Medical MicrobiologyUniversity of Duisburg-EssenEssenGermany

Personalised recommendations