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Infectious Optic Neuropathies
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Imran Rizvi, Ravindra Kumar Garg
Bartonella henselae is a gram-negative bacteria, which is known to cause the zoonotic cat-scratch disease.42 The Bartonella henselae organism is transmitted by the infected cats, through bites, licks or abrasions.42 The cat-scratch disease usually manifests with a flu-like syndrome along with tender lymphadenitis.43 Ocular involvement is described in 5 to 10% of patients.44 The ocular involvement in cat-scratch disease is common. There is a gap of about 4 weeks between inoculation and development of ocular complications. Neuroretinitis is the most common and most characteristic ocular complication.45 Patients can have vision loss, RAPD, color desaturation and visual field abnormalities. The fundus examination shows optic disc edema along with macular star formation. In majority of patients, vision recovers following treatment.46,47 The indirect fluorescent antibody test, enzyme-linked immunoassay (ELISA), Western blot and polymerase chain reaction (PCR)-based assays are used for the laboratory diagnosis.42,43 The treatment guidelines are not clear. Usually patients are treated with doxycycline.48 Alternatively, rifampicin, gentamycin, ciprofloxacin and trimethoprim-sulfamethoxazole have also been used.49
Conjunctiva
Published in Mostafa Khalil, Omar Kouli, The Duke Elder Exam of Ophthalmology, 2019
Omar Kouli, Mostafa Khalil, Rizwan Malik
This is a rare condition caused by various bacterial, fungal and viral agents, most notably Bartonella henselae (cat scratch disease). The syndrome is characterized by a granulomatous unilateral conjunctivitis with ipsilateral preauricular lymphadenopathy associated with a low-grade fever.
Benign Neck Disease
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Ricard Simo, Jean-Pierre Jeannon, Enyinnaya Ofo
Several antibiotics such as gentamicin, rifampicin, ciprofloxacin, and especially azithromycin which is associated with rapid resolution, have been advocated.65 However, antibiotic use in cat scratch disease without systemic symptoms remains controversial given that infections may resolve without treatment.
Clinical Features and Multimodal Imaging in Atypical Posterior Uveitis Secondary to Bartonella Henselae Infection
Published in Ocular Immunology and Inflammation, 2022
Zachary A. Koretz, Anna Apostolopoulou, Edwin Chen, Oliver Beale, Peter Veldkamp, John Alex Viehman, José-Alain Sahel, Jay Chhablani, Kunal K. Dansingani, Marie-Hélène Errera, Gabrielle R. Bonhomme
Cat-scratch disease is a zoonotic infectious disease caused by the gram-negative bacillus Bartonella henselae. Transmission occurs through scratches, bites, and fleas from infected cats, which serve as the main reservoir for the bacterium.1 Cat-scratch disease often presents with fevers and regional lymphadenopathy but presentation is variable, ranging from cutaneous lesions to disseminated disease affecting visceral organs and the nervous system. The two main ocular manifestations of cat scratch disease are Parinaud's oculoglandular syndrome and neuroretinitis. The former occurs in about 5% of patients and presents as tender lymphadenopathy of the face or neck alongside infectious conjunctivitis, blepharitis, or regional cellulitis caused by inoculation of Bartonella into or around the eye.2 On the other hand, neuroretinitis—optic disc edema associated with macular hard exudates—is a relatively rare manifestation of cat-scratch disease, occurring in 1–2% of patients.2 The main symptom is decreased vision, and posterior segment findings may include retinal or choroidal white lesions, optic disc edema, stellate macular exudates, retinal vascular occlusions, or cotton wool spots.3–6 In a retrospective case series, Solley et al. described 24 cases of posterior uveitis secondary to cat-scratch disease. Eighty-three percent of these patients had 1–3 discrete white retinal or choroidal lesions, while 17% had none. In more than half the patients, there was coexistent disc edema and macular exudates.5
A Case of Neuroretinitis Following COVID-19 Vaccination
Published in Ocular Immunology and Inflammation, 2023
Neuroretinitis is an inflammatory condition affecting the retina and optic nerve.3,4 In most cases, only one eye is affected, and bilateral cases are rare.3 In some cases, specific infectious agents have been identified, and the majority of these cases are caused by Bartonella henselae, which causes cat-scratch disease. Other infectious diseases including syphilis, toxoplasmosis, and Lyme disease have also been implicated, while 50% of neuroretinitis cases are idiopathic, also known as Leber’s idiopathic stellate neuroretinitis.4 Some cases present with flu-like prodromes, suggesting that their etiology is an infection by an unidentified pathogen or an infection-induced autoimmune response.5
Cat scratch disease causing encephalitis
Published in Baylor University Medical Center Proceedings, 2020
Our patient had a classic presentation of cat scratch disease, including an isolated lymph node, fever, and exposure to cats. However, this immunocompetent healthy young man quickly progressed to encephalitis. Interestingly, neurologic manifestations were previously believed to be a consequence of immunocompromise. However, more recent evidence suggests that even healthy individuals develop neurologic complications in a small number of cases. Our patient responded well to doxycycline and rifampin for 14 days. When he followed up in the clinic, he had no neurologic complications.