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Ngathaweesuk Y, Hendrikse J, Groot-Mijnes JDFD, de Boer JH, Hettinga YM. Causes of infectious pediatric uveitis: A review. Surv Ophthalmol 2024; 69:483-494. [PMID: 38182040 DOI: 10.1016/j.survophthal.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/11/2023] [Accepted: 12/29/2023] [Indexed: 01/07/2024]
Abstract
Infectious pediatric uveitis is a rare disease that can cause severe ocular damage if not detected rapidly and treated properly. Additionally, early identification of an infection can protect the child from life-threatening systemic infection. Infectious uveitis can be congenital or acquired and may manifest as a primary ocular infection or as a reactivation. Nevertheless, publications on infectious paediatric uveitis are usually limited to a small number of patients or a case report. So far, most studies on uveitis in children have focused primarily on noninfectious uveitis, and a systematic study on infectious uveitis is lacking. In this review, we summarize the literature on infectious uveitis in pediatric populations and report on the epidemiology, pathophysiology, clinical signs, diagnostic tests, and treatment. We will describe the different possible pathogens causing uveitis in childhood by microbiological group (i.e. parasites, viruses, bacteria, and fungi). We aim to contribute to early diagnosis and management of infectious pediatric uveitis, which in turn might improve not only visual outcome, but also the general health outcome.
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Affiliation(s)
- Yaninsiri Ngathaweesuk
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands; Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Jytte Hendrikse
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands.
| | - Jolanda Dorothea Francisca de Groot-Mijnes
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands; Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Joke Helena de Boer
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands
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Li P, Qian Z, Tao Y. Application of metagenomic next-generation sequencing in the diagnosis of Bartonella neuroretinitis: a case report and literature review. J Ophthalmic Inflamm Infect 2024; 14:17. [PMID: 38637335 PMCID: PMC11026355 DOI: 10.1186/s12348-024-00387-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 01/13/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Cat-scratch disease (CSD) is caused by Bartonella henselae infection. In atypical cases of CSD, pathogen determination is challenging. We report a case of Bartonella neuroretinitis with neither a clear history of scratches nor typical general symptoms. The diagnosis was made using metagenomic next-generation sequencing (mNGS), a high-throughput sequencing technology. CASE PRESENTATION A female patient presented to the ophthalmologist with complaint of blurred vision in her right eye. Although with history of raising a cat, she reported no clear history of scratches or typical general symptoms, except a fever of unknown origin which resolved spontaneously. The best corrected visual acuity (BCVA) of the right eye was count fingers. Fundus examination showed optic disc oedema, macular exudates and inferior exudative retinal detachment. Laboratory examination results showed increased value of serum C-reactive protein and erythrocyte sedimentation rate. Ocular involvement of toxoplasmosis, syphilis and tuberculosis were excluded. To identify the possible causative pathogen of the disease, mNGS of aqueous humour sample was performed and 521 reads of B. henselae were identified. Serological test results further showed a positive immunoglobulin G (IgG) titre of 1:64. Taking the contact history, clinical manifestations, mNGS and serological results into consideration, the diagnosis of Bartonella neuroretinitis (ocular CSD) was made. After appropriate treatment, the BCVA of the right eye improved to 20/25 in the last follow-up. Fundus examination showed a normal optic disc and macula, and the exudates had reduced. CONCLUSION mNGS, a fast and unbiased method, can be used to detect B. henselae (if present) in intraocular fluid samples.; however, the results should be interpreted together with the clinical symptoms and other auxiliary test results.
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Affiliation(s)
- Pengcheng Li
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China.
| | - Zhuyun Qian
- Beijing GIANTMED Medical Diagnostics Lab, Beijing, China
- Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, No. 8, South Road of Worker's Stadium Chaoyang District, Beijing, 100020, China
| | - Yong Tao
- Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, No. 8, South Road of Worker's Stadium Chaoyang District, Beijing, 100020, China.
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3
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Carujo A, Santos Silva A, Videira Santos F, Furtado MJ, Vasconcelos AL. Optic Neuritis and Vertebral Osteomyelitis: An Uncommon Presentation of Cat-Scratch Disease. Cureus 2024; 16:e52284. [PMID: 38357045 PMCID: PMC10865162 DOI: 10.7759/cureus.52284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
In cat-scratch disease (CSD), hematogenous spread may result in atypical presentations. Ocular manifestations develop in a minority of patients, with treatment being important in reducing long-term visual sequelae. Bone infection is rare. We present the case of a 52-year-old woman, with close contact with cats, reporting acute unilateral blurred vision and presenting papilledema, optic disc pallor, and peripapillary hemorrhage. Etiologic study of optic neuritis revealed an elevated positive Bartonella IgG; hence, treatment for CSD with doxycycline plus rifampin and corticosteroids was started. Concomitant lumbar pain of increasing intensity warranted magnetic resonance imaging, which revealed L3-L4 vertebral osteomyelitis with spondylodiscitis. Given the temporal link with CSD diagnosis and the significant clinical improvement since its treatment was started, an etiologic link was presumed and antibiotics were prolonged. This case stands out for the presence of distinct atypical CSD manifestations in the same patient. Further studies are needed to determine the optimal treatment for rare manifestations, particularly bone infection.
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Affiliation(s)
- António Carujo
- Infectious Diseases Department, Santo António University Hospital, Porto, PRT
| | - André Santos Silva
- Infectious Diseases Department, Santo António University Hospital, Porto, PRT
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, PRT
| | | | - Maria João Furtado
- Ophthalmology Department, Santo António University Hospital, Porto, PRT
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, PRT
| | - António Ludgero Vasconcelos
- Infectious Diseases Department, Santo António University Hospital, Porto, PRT
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, PRT
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Curi ALL, de-la-Torre A, Schlaen A, Mahendradas P, Biswas J. Pediatric Posterior Infectious Uveitis. Ocul Immunol Inflamm 2023; 31:1944-1954. [PMID: 38096404 DOI: 10.1080/09273948.2023.2284990] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/11/2023] [Indexed: 12/18/2023]
Abstract
PURPOSE To describe the most important cause of infectious posterior uveitis in pediatric patients. METHODS Review of the literature. RESULTS The most important causes of infectious uveitis in pediatric patients are: cat-scratch disease, toxocariasis, tuberculosis, viral diseases and toxoplasmosis. Ocular manifestations include retinitis, neuroretinitis, choroidal granulomas, peripheral granulomas and posterior pole granulomas. CONCLUSION Infectious posterior uveitis is a challenging subject and should be considered in the differential diagnosis of any posterior uveitis in children. Infectious uveitis must be excluded before initiating immunosuppressive therapy.
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Affiliation(s)
- André Luiz Land Curi
- Research Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectious Disease - INI/Fiocruz, Rio de Janeiro, Brazil
| | - Alejandra de-la-Torre
- Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Institute of Translational Medicine (IMT), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Ariel Schlaen
- Department of Ophthalmology, Hospital Universitario Austral, Derqui-Pilar, Argentina
| | | | - Jyortimay Biswas
- Uveitis and Ocular Pathology Department, Sankara Nethralaya, Chennai, India
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Alsberge JB, Nash SK, Lin H. OCULAR BARTONELLOSIS PRESENTING WITH FOCAL CHOROIDITIS, FOCAL RETINITIS, BRANCH RETINAL ARTERY OCCLUSION, AND PARACENTRAL ACUTE MIDDLE MACULOPATHY: LONGITUDINAL MULTIMODAL IMAGING ANALYSIS. Retin Cases Brief Rep 2023; 17:763-766. [PMID: 35976627 DOI: 10.1097/icb.0000000000001296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND/PURPOSE To report an atypical case of ocular bartonellosis evaluated longitudinally with multimodal imaging and review the literature on the less common posterior segment manifestations of bartonella infection. METHODS Case report and review of the literature. RESULTS A 26-year-old man presented with focal choroiditis in the right eye and focal retinitis, a branch retinal artery occlusion, and paracentral acute middle maculopathy in the left eye after a systemic prodrome including headache and lymphadenopathy. Serologic testing revealed positive bartonella immunoglobulin G with a titer of 1:512. The patient was diagnosed with ocular bartonellosis infection and started on systemic doxycycline. The posterior segment findings resolved over the follow-up period, and their resolution was documented with optical coherence tomography. CONCLUSION Neuroretinitis is the classic ocular finding in cat scratch disease, but less common presenting findings may include focal choroiditis, retinitis, and branch retinal artery occlusion. To the best of our knowledge, this is the first report of paracentral acute middle maculopathy secondary to a retinitis-associated branch retinal artery occlusion as a presenting sign in ocular bartonellosis.
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Affiliation(s)
- Joseph B Alsberge
- Department of Ophthalmology, Northwest Permanente, Vancouver, Washington
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Wildner G, Bansal R, Ayyadurai N, Thurau S, Basu S. Pathogenesis of Bacterial Uveitis. Ocul Immunol Inflamm 2023; 31:1396-1404. [PMID: 36622856 DOI: 10.1080/09273948.2022.2155842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/02/2022] [Accepted: 12/02/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE To describe the pathogenesis and the general immune mechanisms of the most frequent causes of bacterial uveitis. METHODOLOGY Narrative review. RESULTS Both extra- and intracellular bacteria can induce uveitis, whereas intracellular bacteria are generally transported into the inner eye via cells of the innate immune system, mainly macrophages. Systemic adaptive immunity is usually induced before the bacteria are localized to the inner eye, and once T and B cells have detected the pathogens behind the blood-eye barriers they elicit an acute and/or chronic inflammatory response deteriorating visual acuity that can severely affect the non-regenerating, intraocular tissues. CONCLUSIONS An understanding of pathogenic mechanisms, and its correlation with clinical and imaging features, can facilitate early recognition of microbial factors and institution of appropriate therapy.
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Affiliation(s)
- Gerhild Wildner
- Department of Ophthalmology, University Hospital, LMU, Munich, Germany
| | - Reema Bansal
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nikitha Ayyadurai
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Stephan Thurau
- Department of Ophthalmology, University Hospital, LMU, Munich, Germany
| | - Soumyava Basu
- Prof Brien Holden Eye Research Center, LV Prasad Eye Institute, Hyderabad, India
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Avaylon J, Lau K, Harter K, Mamoor A, Mehendale R, Ranasinghe L, Durant E, Bains G. Neuroretinitis as a Complication of Cat Scratch Disease. Cureus 2023; 15:e45866. [PMID: 37885521 PMCID: PMC10599218 DOI: 10.7759/cureus.45866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2023] [Indexed: 10/28/2023] Open
Abstract
In this case report, a patient with neuroretinitis from a Bartonella henselae infection is described, and insights into methods to distinguish this type of case from more common etiologies of optic nerve edema are presented. A 21-year-old female with a history of right monocular vision loss due to amblyopia presented to the emergency department (ED) with occipital headache, fever, dizziness, nasal congestion, and painless blurry vision in the left eye for one day. A lumbar puncture found a slightly high opening pressure but no evidence of meningitis. The patient was diagnosed with a viral illness and discharged with outpatient follow-up. The patient, however, had persistent central vision loss and recurring headaches and returned to the ED. Subsequent ultrasound of the patient's optic nerve revealed significant optic nerve swelling. A new working diagnosis of idiopathic intracranial hypertension was made, and the patient was started on oral acetazolamide. On the next day, she was seen by ophthalmology, and recent scratches from her cat were noted on her arm. She tested positive for B. henselae and was started on doxycycline and rifampin. Nearly two weeks after the initial presentation, a macular star pattern, indicative of neuroretinitis, was noted on the fundoscopic exam. The patient had recovered her vision by three months later. In ED cases with unilateral vision loss, early use of point-of-care ultrasound and infection with B. henselae should always be considered. Early serology testing may be warranted to allow for earlier treatment since classic signs of neuroretinitis may not be apparent at the onset.
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Affiliation(s)
- Jaycob Avaylon
- Clinical Sciences, California Northstate University College of Medicine, Elk Grove, USA
| | - Kimberly Lau
- Clinical Sciences, California Northstate University College of Medicine, Elk Grove, USA
| | - Kirk Harter
- Clinical Sciences, California Northstate University College of Medicine, Elk Grove, USA
| | - Azaam Mamoor
- Clinical Sciences, California Northstate University College of Medicine, Elk Grove, USA
| | | | - Leonard Ranasinghe
- Clinical Medicine, California Northstate University College of Medicine, Elk Grove, USA
| | - Edward Durant
- Emergency Medicine, Kaiser Permanente Central Valley, Modesto, USA
| | - Gurvijay Bains
- Emergency Medicine, Kaiser Permanente Central Valley, Modesto, USA
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Akao S, Komori K, Rokutanda R. Self-remitting Bartonella neuroretinitis without a cat scratch. IDCases 2023; 31:e01690. [PMID: 36699968 PMCID: PMC9867945 DOI: 10.1016/j.idcr.2023.e01690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/14/2023] Open
Abstract
•Bartonella infection is a leading cause in patients with neuroretinitis.•Ocular involvement occurs in 5-10% of people with cat-scratch disease (CSD).•Bartonella neuroretinitis presents without systemic signs and symptoms of CSD.•Some cases with bartonella neuroretinitis could be self-remitted.
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9
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A Case of Cat Scratch Disease with Neuroretinitis in a 16-Month-Old Boy. Case Rep Ophthalmol Med 2022; 2022:2841683. [PMID: 36277508 PMCID: PMC9584725 DOI: 10.1155/2022/2841683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose We report a case of neuroretinitis associated with cat scratch disease (CSD) in young children. Method Case report. Results A 16-month-old boy was admitted for a detailed examination and treatment of a fever of unknown origin. Blood tests revealed no significant findings other than a white blood cell count of 16,100/mm3 and C-reactive protein level of 9.89 mg/dL. Computed tomography revealed no relevant findings to determine the causative disease. Antibiotic therapy with cefotaxime was initiated; however, the fever did not resolve. The patient was referred to our department for further examination to detect the cause of the fever. Fundoscopy revealed neuroretinitis in the right eye. His mother reported a history of breeding cats. Cat scratch disease (CSD) was suspected based on the clinical course and fundus findings. Cefotaxime was discontinued, and azithromycin, rifampicin, and prednisolone were administered, following which the fever disappeared and fundus findings improved. Immunoglobulin G (IgG) and IgM antibodies against Bartonella henselae was positive, leading to a definitive diagnosis of CSD. Conclusion Infants cannot complain of decreased visual acuity; therefore, these findings may be overlooked unless a fundus examination is performed. As in this case, the early detection of neuroretinitis by an ophthalmologist may help in the diagnosis of CSD. It is extremely difficult to capture a photograph of the fundus of an infant, and recording with a smartphone is relatively simple and useful for monitoring continuous changes. Summary. We describe a case of neuroretinitis associated with cat scratch disease (CSD) that was diagnosed on the basis of fundus findings. The findings suggest the importance of an aggressive ophthalmologic examination when CSD is suspected in young children who are unable to describe their symptoms.
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Li M, Yan K, Jia P, Wei E, Wang H. Metagenomic next-generation sequencing may assist diagnosis of cat-scratch disease. Front Cell Infect Microbiol 2022; 12:946849. [PMID: 36189365 PMCID: PMC9524480 DOI: 10.3389/fcimb.2022.946849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/26/2022] [Indexed: 11/28/2022] Open
Abstract
Bartonella henselae, the pathogen that causes cat-scratch disease (CSD), is relatively rare in the clinic. CSD usually causes mild clinical manifestations, which self-heal in a matter of weeks. However, in immunocompromised patients, CSD may cause systemic disorders that can lead to critical illness. Due to the diversity of symptom signs and the lack of a golden standard for diagnosis, identifying atypical CSD in a timely manner presents a challenge. Metagenomic next-generation sequencing (mNGS), is a promising technology that has been widely used in the detection of pathogens in clinical infectious diseases in recent years. mNGS can detect multiple pathogens quickly and accurately from any given source. Here, we present a case of atypical CSD, which was diagnosed using mNGS. The patient manifested a fever of unknown infectious origin, and routine antibiotic treatment was ineffective. mNGS was employed to test the patient’s peripheral blood, which led to the detection of B. henselae. This was rarely seen in previous CSD reports. We surmised that the patient presented with atypical CSD and thus a targeted therapy was recommended. Crucially, the patient recovered rapidly. Based on this case study findings, we recommend that CSD should be included in the differential diagnosis for fever of unknown origin and that mNGS may be helpful in the diagnosis of CSD.
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Cute Cats, Disastrous Nightmare. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2022. [DOI: 10.1097/ipc.0000000000001160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ng CC, Ng J, McDonald HR, Cunningham ET. Bartonella henselae-associated recurrent, bilateral segmental periphlebitis. Am J Ophthalmol Case Rep 2022; 26:101475. [PMID: 35321248 PMCID: PMC8935419 DOI: 10.1016/j.ajoc.2022.101475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/23/2022] [Accepted: 03/07/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose To describe a patient with atypical Bartonella henselae (B. henselae)-associated ocular inflammation that manifested with recurrent, bilateral segmental periphlebitis. Observations A 32-year-old White man presented with multiple paracentral scotomata in each eye. Examination revealed mild vitreous cell, segmental sheathing of the retinal veins, and inflammation of the paravenous retina in each eye. Multimodal imaging, including optical coherence tomography as well as widefield fundus autofluorescence, fluorescein angiography, and indocyanine green angiography, was consistent with bilateral, segmental retinal periphlebitis with paravenous inflammation and retinochoroidal scarring. Serology showed elevated B. henselae antibody titers, but was otherwise unrevealing, and the patient was diagnosed with presumed B. henselae-associated ocular inflammation. Treatment with systemic doxycycline (100 mg PO BID) for four weeks improved the patient's symptoms and posterior uveitis. However, after an asymptomatic period of nearly one year, his bilateral pericentral scotomata recurred and posterior segment examination confirmed new foci of retinal periphlebitis in each eye. Re-treatment with doxycycline (100 mg PO BID) for four weeks again yielded improvement, but one month after completing his antibiotic course, his visual symptoms recurred, and we observed additional areas of periphlebitis and paravenous retinitis with associated branch retinal vein occlusions in each eye. This time a dual antibiotic regimen of doxycycline (100 mg PO BID) and rifampin (300 mg PO BID) was administered for three months, with improvement. Over the next eight years, the patient experienced no further disease relapse, and the previous sites of retinal periphlebitis eventually developed perivenous fibrosis with paravenous retinochoroidal scarring. Conclusion Rarely, patients with B. henselae-associated ocular inflammation develop segmental retinal periphlebitis with or without retinal vein occlusion. This form of ocular bartonellosis can recur, requiring multiple courses of antimicrobial therapy.
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Affiliation(s)
- Caleb C. Ng
- Retina Consultants of Orange County, Fullerton, CA, USA
- West Coast Retina Medical Group, San Francisco, CA, USA
- Corresponding author. Retina Consultants of Orange County, 301 W. Bastanchury Road, #285, Fullerton, CA, 9283, USA.
| | - Joshua Ng
- West Coast Retina Medical Group, San Francisco, CA, USA
| | - H. Richard McDonald
- West Coast Retina Medical Group, San Francisco, CA, USA
- The Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA
| | - Emmett T. Cunningham
- West Coast Retina Medical Group, San Francisco, CA, USA
- The Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA
- The Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA
- The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, CA, USA
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Jurja S, Stroe AZ, Pundiche MB, Docu Axelerad S, Mateescu G, Micu AO, Popescu R, Oltean A, Docu Axelerad A. The Clinical Profile of Cat-Scratch Disease’s Neuro-Ophthalmological Effects. Brain Sci 2022; 12:brainsci12020217. [PMID: 35203980 PMCID: PMC8870711 DOI: 10.3390/brainsci12020217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/28/2022] [Accepted: 02/03/2022] [Indexed: 12/29/2022] Open
Abstract
Cat-scratch disease is an illness caused by Bartonella henselae that occurs as a result of contact with an infected kitten or dog, such as a bite or scratch. It is more prevalent in children and young adults, as well as immunocompromised individuals. There are limited publications examining the features of CSD in patients. As such, the purpose of this research was to assess the clinical neuro-ophthalmological consequences of CSD reported in the literature. Among the ophthalmologic disorders caused by cat-scratch disease in humans, Parinaud oculoglandular syndrome, uveitis, vitritis, retinitis, retinochoroiditis and optic neuritis are the most prevalent. The neurological disorders caused by cat-scratch disease in humans include encephalopathy, transverse myelitis, radiculitis, and cerebellar ataxia. The current review addresses the neuro-ophthalmological clinical manifestations of cat-scratch disease, as described in papers published over the last four decades (1980–2022). All the data gathered were obtained from PubMed, Medline and Google Scholar. The current descriptive review summarizes the most-often-encountered clinical symptomatology in instances of cat-scratch disease with neurological and ocular invasion. Thus, the purpose of this review is to increase knowledge of cat-scratch disease’s neuro-ophthalmological manifestations.
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Affiliation(s)
- Sanda Jurja
- Department of Ophthalmology, Faculty of Medicine, ‘Ovidius’ University of Constanta, 900527 Constanta, Romania;
- County Emergency Clinical Hospital “Sf. Apostol Andrei”, Tomis Street, nr. 145, 900591 Constanta, Romania; (M.B.P.); (A.D.A.)
| | - Alina Zorina Stroe
- County Emergency Clinical Hospital “Sf. Apostol Andrei”, Tomis Street, nr. 145, 900591 Constanta, Romania; (M.B.P.); (A.D.A.)
- Department of Neurology, General Medicine Faculty, Ovidius University, 900470 Constanta, Romania
- Correspondence: ; Tel.: +40-727-987-950
| | - Mihaela Butcaru Pundiche
- County Emergency Clinical Hospital “Sf. Apostol Andrei”, Tomis Street, nr. 145, 900591 Constanta, Romania; (M.B.P.); (A.D.A.)
- Surgery Department, Faculty of General Medicine, ‘Ovidius’ University of Constanta, 900470 Constanta, Romania
| | | | - Garofita Mateescu
- Morphology Department, Faculty of Medicine, University of Medicine and Pharmacy, 200349 Craiova, Romania;
| | - Alexandru Octavian Micu
- Department of Economic Engineering in Transports, Maritime University of Constanta, Str. Mircea cel Bătrân, 104, 900663 Constanta, Romania;
| | - Raducu Popescu
- Physical Education, Sport and Kinetotherapy Department, ‘Ovidius’ University of Constanta, 900470 Constanta, Romania; (R.P.); (A.O.)
| | - Antoanela Oltean
- Physical Education, Sport and Kinetotherapy Department, ‘Ovidius’ University of Constanta, 900470 Constanta, Romania; (R.P.); (A.O.)
| | - Any Docu Axelerad
- County Emergency Clinical Hospital “Sf. Apostol Andrei”, Tomis Street, nr. 145, 900591 Constanta, Romania; (M.B.P.); (A.D.A.)
- Department of Neurology, General Medicine Faculty, Ovidius University, 900470 Constanta, Romania
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A Teenager With Fevers and Progressive Visual Impairment. Pediatr Infect Dis J 2022; 41:175-177. [PMID: 33902080 DOI: 10.1097/inf.0000000000003142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Michel Z, Redd T, Bhavsar KV. MULTIMODAL IMAGING OF TWO UNCONVENTIONAL CASES OF BARTONELLA NEURORETINITIS. Retin Cases Brief Rep 2022; 16:40-43. [PMID: 31348120 DOI: 10.1097/icb.0000000000000893] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
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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Affiliation(s)
- Zachary Michel
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon; and
| | - Travis Redd
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon; and
| | - Kavita V Bhavsar
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon; and
- Portland VA Healthcare System, Portland, Oregon
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Fleissig E, Kim F, Sigford DK, Barr CC. Bilateral neuroretinits and exudative retinal detachment with multifocal subretinal deposits secondary to Bartonella henselae infection. Am J Ophthalmol Case Rep 2021; 24:101201. [PMID: 34541379 PMCID: PMC8437794 DOI: 10.1016/j.ajoc.2021.101201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 07/23/2021] [Accepted: 08/31/2021] [Indexed: 11/01/2022] Open
Abstract
Purpose to describe a case of bilateral neuroretinitis with bullous retinal detachment and multiple subretinal lesions, in a 10-year-old immunocompetent girl. Observations A broad workup for infectious, inflammatory and masquerade etiologies was done for the patient, resulting in positive IgM and IgG for Bartonella henselae. The patient demonstrated improvement in the visual acuity, and rapid resolution of the retinal detachment and subretinal lesions in both eyes in response to systemic rifampin, doxycycline and corticosteroids. Conclusions and Importance Bartonella henselae neuroretinitis may present as an acute form of bullous retinal detachment with multiple subretinal lesions and markedly reduced vision. Significant visual improvement may occur with prompt treatment with a combination of systemic antibiotics and corticosteroids.
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Affiliation(s)
- Efrat Fleissig
- Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, Louisville, KY, USA.,Department of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine,Tel-Aviv University, Tel-Aviv, Israel
| | - Fiona Kim
- Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, Louisville, KY, USA
| | - Douglas Kenneth Sigford
- Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, Louisville, KY, USA
| | - Charles C Barr
- Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, Louisville, KY, USA
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17
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Albert DM, Salman AR, Winthrop KL, Bartley GB. The Continuing Ophthalmic Challenge of Bartonella henselae. OPHTHALMOLOGY SCIENCE 2021; 1:100048. [PMID: 36247815 PMCID: PMC9559971 DOI: 10.1016/j.xops.2021.100048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/02/2022]
Abstract
Purpose Methods Results Conclusions
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18
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Nawrocki CC, Max RJ, Marzec NS, Nelson CA. Atypical Manifestations of Cat-Scratch Disease, United States, 2005-2014. Emerg Infect Dis 2021; 26:1438-1446. [PMID: 32568056 PMCID: PMC7323523 DOI: 10.3201/eid2607.200034] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Atypical manifestations that can be severe and difficult to diagnosis develop in 5%-20% of patients with cat-scratch disease. To clarify the epidemiology of atypical cat-scratch disease in the United States, we analyzed data from the 2005-2014 MarketScan national health insurance claims databases by using the International Classification of Diseases, 9th Revision, Clinical Modification, codes for cat-scratch disease and selected atypical manifestations: retinitis/neuroretinitis, conjunctivitis, neuritis, encephalitis, hepatosplenic disease, osteomyelitis, erythema nodosum, and endocarditis. Atypical cat-scratch disease accounted for 1.5% of all cases, resulting in an average annual incidence of 0.7 cases/100,000 population. Atypical cat-scratch disease was associated with increased risk for hospitalization (risk ratios 8.77, 95% CI 6.56-11.72) and occurred most often in female patients 10-14 years of age. Ocular (48.7%), hepatosplenic (24.6%), and neurologic (13.8%) manifestations were most common among patients. A more comprehensive understanding of atypical cat-scratch disease can improve patient diagnosis and potentially elucidate pathophysiology of the disease.
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19
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Yehudina Y, Trypilka S. Case Reports of Cat Scratch Disease in Patient With Unjustified Surgical Intervention. Cureus 2021; 13:e14632. [PMID: 34055506 PMCID: PMC8144071 DOI: 10.7759/cureus.14632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Cat scratch disease (CSD) is often a rare and unrecognized illness, but it is important for practitioners to consider. CSD is commonly diagnosed in children, but adults may also get this disease. The manifestations of CSD can include the damage of internal organs, joints, eyes, heart, and kidneys. CSD should be included in the differential diagnoses of fever of unknown origin and any lymphadenopathy syndrome. For rheumatologists, this pathology is of interest due to the systemic involvement, as well as the disease debut from the musculoskeletal symptoms. We present a CSD clinical case of a patient whose disease began with an acute abdomen clinic, and after two months transformed into arthritis of the hand joints.
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Affiliation(s)
| | - Svitlana Trypilka
- Rheumatologist Policlinic Department, Communal Non-Commercial Enterprise of Kharkov Regional Council "Regional Clinical Hospital", Kharkiv, UKR
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20
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Candelore R, Krieger J, Couperus K, Harvey M. Female with right eye scotoma. J Am Coll Emerg Physicians Open 2021; 2:e12402. [PMID: 33969339 PMCID: PMC8082705 DOI: 10.1002/emp2.12402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 02/11/2021] [Indexed: 11/07/2022] Open
Affiliation(s)
- Ross Candelore
- Department of Emergency MedicineMadigan Army Medical CenterJoint Base Lewis‐McChordWashingtonUSA
| | | | - Kyle Couperus
- Department of Emergency MedicineMadigan Army Medical CenterJoint Base Lewis‐McChordWashingtonUSA
- University of WashingtonSeattleWashingtonUSA
| | - Maxine Harvey
- Department of Ophthalmology, Madigan Army Medical CenterJoint Base Lewis‐McChordWashingtonUSA
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21
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Arıcı N, Aksaray S, Ankaralı H. Bartonella henselae IgM seropositivity in both adult and pediatric patients with diverse clinical conditions in Turkey. Acta Microbiol Immunol Hung 2021; 68:14-19. [PMID: 33661136 DOI: 10.1556/030.2021.01310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/04/2020] [Indexed: 11/19/2022]
Abstract
Bartonella henselae is the causative agent of cat scratch disease (CSD). In this study, we aimed to investigate the clinical data of patients with suspicion of CSD and delineate current epidemiological features.A total of 785 patients with suspected CSD were included in the study. B. henselae IgM antibody was determined by indirect fluorescent antibody (IFA) test using a commercial kit (Euroimmun, Germany). Sex, age, clinical pre-diagnosis and animal contact information of the patients were obtained from hospital electronic database records.Seventy-eight (9.9%) of 785 samples were seropositive. Out of 78 patients, 46 with animal contact data were further analyzed. Of these patients, 56% were male, and 41% were under 18 years of age. Seropositivity was more commonly observed in fall and winter. The most common finding was lymphadenitis (63%). Thirty-five patients (76%) had a previous history of animal contact (cat/dog). Of the 46 seropositive patients, 78.3, 15.2, 4.4, and 2.1% had titers of 1:80, 1:160, 1:320, and 1:640, respectively.Our study confirms that CSD is not rare in Turkey. Thus, it should always be considered in the differential diagnosis of patients presenting with lymphadenopathy in all age groups, particularly children. Questioning of cat exposure should never be neglected, especially in areas with intense population of stray cats, such as Istanbul.
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Affiliation(s)
- Neslihan Arıcı
- 1Haydarpasa Research and Training Hospital, Microbiology Laboratory, T.C. University of Health Sciences, Istanbul, Turkey
| | - Sebahat Aksaray
- 2Department of Medical Microbiology, Faculty of Medicine Hamidiye, T.C. University of Health Sciences, Istanbul, Turkey
| | - Handan Ankaralı
- 3Department of Bioistatistic, Faculty of Medicine, Medeniyet University, Istanbul, Turkey
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22
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El Matri K, Falfoul Y, Amoroso F, Souied EH, Dekli Z, Chebil A, Mili-Boussen I, Khairallah M, El Matri L. Multimodal imaging of branch retinal artery occlusion and multiple retinal infiltrates associated to cat's scratch disease. J Fr Ophtalmol 2021; 44:e199-e204. [PMID: 33451868 DOI: 10.1016/j.jfo.2020.06.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/11/2020] [Indexed: 11/28/2022]
Affiliation(s)
- K El Matri
- Institut Hédi Rais d'ophtalmologie de Tunis, Department B / Oculogenetic laboratory LR14SP01, boulevard du 9 Avril 1938, 1006 Tunis, Tunisia; Université Tunis - El Manar, Faculté de médecine de Tunis, rue Djebal Lakhdar, 1006 Tunis, Tunisia; Centre hospitalier intercommunal de Créteil, Ophthalmology department, 40 avenue de Verdun, 94000 Créteil, France; Université Paris-Est Créteil, Faculté de médecine de Créteil, 8, rue du Général Sarrail, 94000 Créteil, France.
| | - Y Falfoul
- Institut Hédi Rais d'ophtalmologie de Tunis, Department B / Oculogenetic laboratory LR14SP01, boulevard du 9 Avril 1938, 1006 Tunis, Tunisia
| | - F Amoroso
- Centre hospitalier intercommunal de Créteil, Ophthalmology department, 40 avenue de Verdun, 94000 Créteil, France; Université Paris-Est Créteil, Faculté de médecine de Créteil, 8, rue du Général Sarrail, 94000 Créteil, France
| | - E H Souied
- Centre hospitalier intercommunal de Créteil, Ophthalmology department, 40 avenue de Verdun, 94000 Créteil, France; Université Paris-Est Créteil, Faculté de médecine de Créteil, 8, rue du Général Sarrail, 94000 Créteil, France
| | - Z Dekli
- Institut Hédi Rais d'ophtalmologie de Tunis, Department B / Oculogenetic laboratory LR14SP01, boulevard du 9 Avril 1938, 1006 Tunis, Tunisia; Université Tunis - El Manar, Faculté de médecine de Tunis, rue Djebal Lakhdar, 1006 Tunis, Tunisia
| | - A Chebil
- Institut Hédi Rais d'ophtalmologie de Tunis, Department B / Oculogenetic laboratory LR14SP01, boulevard du 9 Avril 1938, 1006 Tunis, Tunisia; Université Tunis - El Manar, Faculté de médecine de Tunis, rue Djebal Lakhdar, 1006 Tunis, Tunisia
| | - I Mili-Boussen
- Université Tunis - El Manar, Faculté de médecine de Tunis, rue Djebal Lakhdar, 1006 Tunis, Tunisia; Centre hospitalier universitaire Charles Nicolle, Ophthalmology department boulevard du 9-Avril 1938, Tunis, Tunisia
| | - M Khairallah
- Service d'ophtalmologie, Hôpital universitaire Fattouma Bourguiba, avenue Farhat Hached, 5000 Monastir, Tunisia; Université de Monastir, Faculté de médecine de Monastir, avenue Avicenne, 5000 Monastir, Tunisia
| | - L El Matri
- Institut Hédi Rais d'ophtalmologie de Tunis, Department B / Oculogenetic laboratory LR14SP01, boulevard du 9 Avril 1938, 1006 Tunis, Tunisia; Université Tunis - El Manar, Faculté de médecine de Tunis, rue Djebal Lakhdar, 1006 Tunis, Tunisia
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Annoura K, Sano I, Makino S, Kawashima H. Multiple ocular manifestations in a case of cat scratch disease without systemic signs. GMS OPHTHALMOLOGY CASES 2020; 10:Doc45. [PMID: 33384912 PMCID: PMC7745642 DOI: 10.3205/oc000172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
A 43-year-old woman presented with impaired vision and redness in her left eye of 2 weeks duration. She had a pet cat that scratched her forehead 3 weeks before she presented to us. She had no systemic signs such as lymphadenopathy, fever, or fatigue. The respective right and left corrected visual acuities were 20/16 and 20/2000. The anterior chamber of the left eye exhibited inflammation; a fundus examination of that eye revealed optic disc swelling and a serous macular detachment with hard stellate exudates. Based on the recent cat scratch and the ocular findings, cat scratch disease (CSD) was suspected. The results of serologic testing showed elevated titres of IgM and IgG antibodies to Bartonella henselae. Administration of doxycycline and a steroid was initiated. This report describes the occurrence of multiple ocular manifestations of CSD in both the posterior and the anterior segment.
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Affiliation(s)
- Kanako Annoura
- Department of Ophthalmology, Jichi Medical University, Shimotsuke-shi, Japan
| | - Ichiya Sano
- Department of Ophthalmology, Jichi Medical University, Shimotsuke-shi, Japan,*To whom correspondence should be addressed: Ichiya Sano, Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi 329-0498, Japan, E-mail:
| | - Shinji Makino
- Department of Ophthalmology, Jichi Medical University, Shimotsuke-shi, Japan
| | - Hidetoshi Kawashima
- Department of Ophthalmology, Jichi Medical University, Shimotsuke-shi, Japan
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24
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Tey MSY, Govindasamy G, Vendargon FM. The clinical spectrum of ocular bartonellosis: a retrospective study at a tertiary centre in Malaysia. J Ophthalmic Inflamm Infect 2020; 10:31. [PMID: 33191467 PMCID: PMC7667203 DOI: 10.1186/s12348-020-00224-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 10/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cat scratch disease (CSD) is a systemic illness caused by the gram-negative bacillus, Bartonella henselea, which can occasionally involve the ocular structures. The objective of this study is to evaluate the various clinical presentations of ocular bartonellosis at our institution. A retrospective review of the clinical records of 13 patients (23 eyes) with ocular manifestations of Bartonella infections over a 3-year period between January 2016 to December 2018 was undertaken at our institution. RESULTS The diagnosis was made based on clinical findings and in addition, with the support of the evidence of Bartonella hensalae IgG and/or IgM. Small retinal white lesions were the most common ocular findings in this series of patients (82.6% of eyes, 76.9% of patients). Neuroretinitis was the second most common finding (47.8% of eyes, 69.2% of patients), followed by exudative retinal detachment involving the macula (34.8% of eyes, 53.8% of patients) and Parinaud's oculoglandular syndrome (17.4% of eyes, 23.1% of patients). Other findings like isolated optic disc oedema without macular star (8.7% of eyes, 15.4% of patients) and vitritis (4.3% of eyes, 7.7% of patients) were also observed. Ten patients (76.9%) had bilateral ocular involvement. Most of the patients were young, immunocompetent and had systemic symptoms like fever prior to their ocular symptoms. The visual acuity (VA) at initial presentation ranged from 6/6 to hand movement (mean, 6/20), and at final visit 6/6 to 6/60, (mean, 6/9). 91.7% of patients were treated with antibiotics. Only 2 patients received oral corticosteroids together with antibiotics due to very poor vision on presentation. The visual prognosis of ocular bartonellosis is generally good with 16 (88.9%) of 23 eyes having VA of 6/12 or better at final follow-up visit. CONCLUSION Small foci of retinal white lesions were the most common manifestation of ocular bartonellosis in this series, followed by neuroretinitis, though an array of other ocular findings may also occur. Therefore, we should consider bartonella infection as a possible differential diagnosis in those patients.
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Affiliation(s)
- Michele Shi-Ying Tey
- Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia.
| | - Gayathri Govindasamy
- Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
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25
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Orellana-Rios J, Verdaguer-Diaz JI, Opazo G, Leong BCS, Zett C, Smith RT, Freund KB. Not cat-scratch disease: Bartonella henselae neuroretinitis associated with non-feline pet mammals. IDCases 2020; 22:e00978. [PMID: 33083230 PMCID: PMC7554364 DOI: 10.1016/j.idcr.2020.e00978] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/27/2020] [Accepted: 09/27/2020] [Indexed: 11/26/2022] Open
Abstract
To describe the ocurrence of Bartonella-associated neuroretinitis secondary to non-feline pet exposure, we retrospectively reviewed medical records and imaging from patients with a clinical and serologic diagnosis of Bartonella henselae (BH). Retinal imaging included color fundus photography, optical coherence tomography (OCT) and fluorescein angiography (FA). Four eyes of two patients with cat-scratch disease were included in this study, with a mean age of 35 years. The mean follow-up was 13 months, after presentation of infectious neuroretinitis. Both patients suffered from bilateral neuroretinitis after direct contact with family pets (ferret and guinea pig). All patients were treated with a long-term systemic antimicrobial therapy. Visual acuity in all improved to 20/30 or better at six months. In conclusion, humans may develop cat-scratch disease when they are exposed to Bartonella henselae (BH) in the saliva of infected cats or BH-containing flea feces reaching the systemic circulation through scratches or mucous membranes. As the cat flea (Ctenocephalides felis) may reside on non-feline mammals, Bartonella-associated neuroretinitis may result from contact with other furred family pets.
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Affiliation(s)
- Jorge Orellana-Rios
- Fundación Oftalmológica Los Andes, Vitacura, Santiago, Chile.,Centro Oftalmológico Láser CEOLA, Antofagasta, Chile
| | | | | | | | - Claudio Zett
- Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - R Theodore Smith
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, USA.,Department of Ophthalmology, New York University, School of Medicine, New York, USA
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26
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Shariffudin NS, Min TW, Adnan A, Hashim H, Teo KSS. A child with a rare presentation of ocular bartonellosis. Taiwan J Ophthalmol 2020; 11:292-295. [PMID: 34703746 PMCID: PMC8493987 DOI: 10.4103/tjo.tjo_29_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/22/2020] [Indexed: 11/04/2022] Open
Abstract
A 6-year-old boy was referred from the optometrist for bilateral painless blurred vision of 2 weeks duration during routine screening. Upon examination, best-corrected visual acuity was 20/200 (right eye) and 20/120 (left eye). Anterior segment examination was normal for both eyes. Funduscopy showed bilateral optic disc swelling with peripapillary exudates and diffuse retinochoroiditis involving the posterior pole. Optical coherence tomography revealed diffuse retinal thickening with intraretinal fluids and cystoid changes of central fovea. Fluorescein angiography showed bilateral hot discs with vasculitis in all quadrants and large areas of nonperfusion at peripheral retina. The patient was initially treated as presumed ocular tuberculosis (TB) based on clinical presentation and history of contact with family member having pulmonary TB. Antituberculous therapy was started and both eyes received panretinal laser photocoagulation. After 3 weeks of anti-TB treatment, serology for Bartonella turned out to be positive. Treatment was changed to intravenous ceftriaxone for 10 days followed by oral cotrimoxazole for 6 weeks and combined treatment with oral prednisolone. Gradual clinical improvement was seen with corresponding visual gain due to the reduction of macular edema, but residual thickening remained due to its chronicity.
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Affiliation(s)
- Nor Syahira Shariffudin
- Department of Ophthalmology, Hospital Selayang, Batu Caves, Selangor, Malaysia.,Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Teh Wee Min
- Department of Ophthalmology, Hospital Selayang, Batu Caves, Selangor, Malaysia
| | - Azian Adnan
- Department of Ophthalmology, Hospital Selayang, Batu Caves, Selangor, Malaysia
| | - Hanizasurana Hashim
- Department of Ophthalmology, Hospital Selayang, Batu Caves, Selangor, Malaysia
| | - Khairy Shamel Sonny Teo
- Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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27
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Dixon MK, Dayton CL, Anstead GM. Parinaud's Oculoglandular Syndrome: A Case in an Adult with Flea-Borne Typhus and a Review. Trop Med Infect Dis 2020; 5:E126. [PMID: 32751142 PMCID: PMC7558689 DOI: 10.3390/tropicalmed5030126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/13/2020] [Accepted: 07/24/2020] [Indexed: 11/16/2022] Open
Abstract
Parinaud's oculoglandular syndrome (POGS) is defined as unilateral granulomatous conjunctivitis and facial lymphadenopathy. The aims of the current study are to describe a case of POGS with uveitis due to flea-borne typhus (FBT) and to present a diagnostic and therapeutic approach to POGS. The patient, a 38-year old man, presented with persistent unilateral eye pain, fever, rash, preauricular and submandibular lymphadenopathy, and laboratory findings of FBT: hyponatremia, elevated transaminase and lactate dehydrogenase levels, thrombocytopenia, and hypoalbuminemia. His condition rapidly improved after starting doxycycline. Soon after hospitalization, he was diagnosed with uveitis, which responded to topical prednisolone. To derive a diagnostic and empiric therapeutic approach to POGS, we reviewed the cases of POGS from its various causes since 1976 to discern epidemiologic clues and determine successful diagnostic techniques and therapies; we found multiple cases due to cat scratch disease (CSD; due to Bartonella henselae) (twelve), tularemia (ten), sporotrichosis (three), Rickettsia conorii (three), R. typhi/felis (two), and herpes simplex virus (two) and single cases due to tuberculosis, paracoccidioidomycosis, Yersinia enterocolitica, Pasteurella multocida, Chlamydia trachomatis, Epstein-Barr virus, and Nocardia brasiliensis. Preauricular lymphadenopathy is a common clinical clue for POGS and is unusual in viral and bacterial conjunctivitis. For POGS, the major etiological consideration is B. henselae, which is usually diagnosed by the indirect immunofluorescence serologic technique. Although CSD POGS is usually self-limited, oral azithromycin may hasten resolution. However, other possible etiologies of POGS may also arise from cat or cat flea contact: sporotrichosis, tularemia, Pasteurella multocida, or FBT. If there is no cat contact, other epidemiologic and clinical findings should be sought, because several of these conditions, such as tularemia, paracoccidioidomycosis, and tuberculosis, may have grave systemic complications. Although there are usually no long-term ocular sequelae if POGS is properly diagnosed, it still may cause prolonged ocular discomfort and require multiple physician contacts.
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Affiliation(s)
- M. Kevin Dixon
- Baylor Scott & White Clinic, 800 Scott & White Drive, College Station, TX 77845, USA;
| | - Christopher L. Dayton
- Division of Critical Care, Department of Medicine, University of Texas Health, San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA;
| | - Gregory M. Anstead
- Medical Service, South Texas Veterans Health Care System, San Antonio, TX 78229, USA
- Division of Infectious Diseases, Department of Medicine, University of Texas Health, San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
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28
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Overgaauw PA, Vinke CM, van Hagen MA, Lipman LJ. A One Health Perspective on the Human-Companion Animal Relationship with Emphasis on Zoonotic Aspects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3789. [PMID: 32471058 PMCID: PMC7312520 DOI: 10.3390/ijerph17113789] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/21/2020] [Accepted: 05/24/2020] [Indexed: 12/15/2022]
Abstract
Over time the human-animal bond has been changed. For instance, the role of pets has changed from work animals (protecting houses, catching mice) to animals with a social function, giving companionship. Pets can be important for the physical and mental health of their owners but may also transmit zoonotic infections. The One Health initiative is a worldwide strategy for expanding collaborations in all aspects of health care for humans, animals, and the environment. However, in One Health communications the role of particularly dogs and cats is often underestimated. OBJECTIVE Evaluation of positive and negative One Health issues of the human-companion animal relationship with a focus on zoonotic aspects of cats and dogs in industrialized countries. METHOD Literature review. RESULTS Pets undoubtedly have a positive effect on human health, while owners are increasing aware of pet's health and welfare. The changing attitude of humans with regard to pets and their environment can also lead to negative effects such as changes in feeding practices, extreme breeding, and behavioral problems, and anthropozoonoses. For the human, there may be a higher risk of the transmission of zoonotic infections due to trends such as sleeping with pets, allowing pets to lick the face or wounds, bite accidents, keeping exotic animals, the importation of rescue dogs, and soil contact. CONCLUSIONS One Health issues need frequently re-evaluated as the close human-animal relationship with pet animals can totally differ compared to decennia ago. Because of the changed human-companion animal bond, recommendations regarding responsible pet-ownership, including normal hygienic practices, responsible breeding, feeding, housing, and mental and physical challenges conforming the biology of the animal are required. Education can be performed by vets and physicians as part of the One Health concept.
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Affiliation(s)
- Paul A.M. Overgaauw
- Department Population Health Sciences, Division of Veterinary Public Health, Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands;
| | - Claudia M. Vinke
- Unit Animals in Science & Society, Animal Behaviour, Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, P.O. Box 80166, 3508 TD Utrecht, The Netherlands; (C.M.V.); (M.A.E.v.H.)
| | - Marjan A.E. van Hagen
- Unit Animals in Science & Society, Animal Behaviour, Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, P.O. Box 80166, 3508 TD Utrecht, The Netherlands; (C.M.V.); (M.A.E.v.H.)
| | - Len J.A. Lipman
- Department Population Health Sciences, Division of Veterinary Public Health, Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands;
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Eloubeidi DM, Kilpatrick DL, Crosson JN. Branch retinal artery occlusion secondary to Bartonella henselae infection in a 13 year-old. Am J Ophthalmol Case Rep 2020; 19:100734. [PMID: 32435719 PMCID: PMC7229482 DOI: 10.1016/j.ajoc.2020.100734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 05/03/2020] [Indexed: 11/28/2022] Open
Abstract
Purpose To summarize the case of a 13 year-old boy diagnosed with a BRAO secondary to B. henselae infection. Observations The patient presented with a sudden, unilateral, and painless scotoma. Fundoscopic findings and multimodal imaging were consistent with a BRAO with associated areas of intraretinal whitening along the involved artery. Upon further questioning, the patient reported having 15 cats at home. Antibodies were positive for B. henselae. The patient was treated with oral doxycycline 100 mg twice daily for 2 months with complete resolution of the retinal findings and the scotoma. Conclusions and importance B. henselae should be considered as a potential cause of retinitis and BRAO, even in pediatric-aged patients.
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Affiliation(s)
| | - David L Kilpatrick
- Retina Consultants of Alabama, P.C., USA.,The University of Alabama at Birmingham School of Medicine, Department of Ophthalmology, USA
| | - Jason N Crosson
- Retina Consultants of Alabama, P.C., USA.,The University of Alabama at Birmingham School of Medicine, Department of Ophthalmology, USA
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30
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Mozo Cuadrado M, Tabuenca del Barrio L, Mosquera Pedreiro S, García Guevara K. Conjuntivitis granulomatosa en 2 pacientes jóvenes. Enferm Infecc Microbiol Clin 2020; 38:238-239. [DOI: 10.1016/j.eimc.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 07/31/2019] [Accepted: 08/22/2019] [Indexed: 10/25/2022]
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Johnson A. Ocular complications of cat scratch disease. Br J Ophthalmol 2020; 104:1640-1646. [PMID: 32122915 DOI: 10.1136/bjophthalmol-2019-315239] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/22/2020] [Accepted: 02/13/2020] [Indexed: 11/03/2022]
Abstract
Cat scratch disease (CSD) in humans is caused by infection with Bartonella henselae or other Bartonella spp. The name of the disease reflects the fact that patients frequently have a history of contact (often involving bites or scratches) with infected cats. Patients with CSD typically develop lesions at the site where the skin is broken together with regional lymphadenopathy but may go on to exhibit systemic symptoms and with deep-seated infections at a range of sites including the eye. Patients with CSD may present with a range of inflammatory eye conditions, including Parinaud's oculoglandular syndrome, neuroretinitis, multifocal retinitis, uveitis and retinal artery occlusion. Bartonella spp. are fastidious bacteria that are difficult to culture from clinical specimens so microbiological diagnosis is frequently made on the basis of positive serology for anti-Bartonella antibodies or detection of bacterial DNA by PCR. Due to the lack of clinical trials, the evidence base for optimal management of patients with CSD-associated eye infections (including the role of antibiotics) is weak, being derived from single reports or small, uncontrolled case series.
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Affiliation(s)
- Alan Johnson
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London W12 0NN, UK
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32
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Ksiaa I, Abroug N, Mahmoud A, Zina S, Hedayatfar A, Attia S, Khochtali S, Khairallah M. Update on Bartonella neuroretinitis. J Curr Ophthalmol 2019; 31:254-261. [PMID: 31528758 PMCID: PMC6742623 DOI: 10.1016/j.joco.2019.03.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/24/2019] [Accepted: 03/26/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To review the clinical features, diagnosis, treatment modalities, and prognosis of Bartonella-associated neuroretinitis. METHODS This is a narrative review on Bartonella-associated neuroretinitis including general and ophthalmological aspects of the disease. A comprehensive literature review between January 1950 and September 2018 was conducted in PubMed database. Epidemiology, clinical features, diagnosis, treatment, and prognosis of Bartonella neuroretinitis were reviewed. RESULTS Cat scratch disease (CSD) is a worldwide distributed systemic infectious disease caused by a bacterium, Bartonella henselae (B. henselae) which is usually transmitted to humans through contact with infected cats. Ocular manifestations of CSD are diverse, with neuroretinitis and superficial retinal infiltrates being the most common and typical manifestations. Neuroretinitis typically presents as optic disc edema with a partial or complete macular star in association with mild vitritis. Macular star may be absent at the initial presentation, becoming evident 1-2 weeks after the onset of optic disc edema. Diagnosis of CSD is confirmed by reliable laboratory tests. Neuroretinitis usually has a self-limited course. Antibiotic therapy is required for severe systemic disease and vision-threatening ocular involvement. The adjunctive use of oral corticosteroids may further improve the visual outcome. CONCLUSIONS The diagnosis of Bartonella-associated neuroretinitis is based on typical clinical findings and positive serology. The prognosis is usually favorable in immunocompetent individuals.
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Affiliation(s)
- Imen Ksiaa
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Nesrine Abroug
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Anis Mahmoud
- Department of Ophthalmology, Tahar Sfar University Hospital, Mahdia, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Sourour Zina
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Alireza Hedayatfar
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Sonia Attia
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Sana Khochtali
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Moncef Khairallah
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
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Shanmugam VK, Phillpotts M, Brady T, Dalal M, Haji-Momenian S, Akin E, Nataranjan K, McNish S, Karcher DS. Retinal vasculitis with Chronic Recurrent Multifocal Osteomyelitis: a case report and review of the literature. BMC Rheumatol 2019; 3:29. [PMID: 31388650 PMCID: PMC6676622 DOI: 10.1186/s41927-019-0076-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 06/24/2019] [Indexed: 12/22/2022] Open
Abstract
Background Concurrent presentation of retinal vasculitis with mixed sclerotic and lytic bone lesions is rare. Case presentation We present the case of a 37-year old woman with a several year history of episodic sternoclavicular pain who presented for rheumatologic evaluation due to a recent diagnosis of retinal vasculitis. We review the differential diagnosis of retinal vasculitis, along with the differential diagnosis of mixed sclerotic and lytic bone lesions. Ultimately, bone marrow biopsy confirmed diagnosis of chronic recurrent multifocal osteomyelitis (CRMO). Concurrent presentation of CRMO with retinal vasculitis is extremely rare but important to recognize. The patient demonstrated clinical response to prednisone and tumor necrosis factor-alpha inhibition (TNF-i). Conclusion This case reports and unusual presentation of CRMO spectrum disease involving the sternum and sternoclavicular joint with concurrent retinal vasculitis.
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Affiliation(s)
- Victoria K Shanmugam
- 1Division of Rheumatology, The George Washington University School of Medicine and Health Sciences, 2300 M Street, NW, Washington, DC 20037 USA
| | - Marc Phillpotts
- 1Division of Rheumatology, The George Washington University School of Medicine and Health Sciences, 2300 M Street, NW, Washington, DC 20037 USA
| | - Timothy Brady
- 1Division of Rheumatology, The George Washington University School of Medicine and Health Sciences, 2300 M Street, NW, Washington, DC 20037 USA
| | - Monica Dalal
- 2Department of Ophthalmology, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue NW, Washington, DC 20037 USA
| | - Shawn Haji-Momenian
- 3Department of Radiology, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue NW, Washington, DC 20037 USA
| | - Esma Akin
- 3Department of Radiology, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue NW, Washington, DC 20037 USA
| | - Kavita Nataranjan
- 4Department of Hematology, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue NW, Washington, DC 20037 USA
| | - Sean McNish
- 1Division of Rheumatology, The George Washington University School of Medicine and Health Sciences, 2300 M Street, NW, Washington, DC 20037 USA
| | - Donald S Karcher
- 5Department of Pathology, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue NW, Washington, DC 20037 USA
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Gunzenhauser RC, Rubino SM, John V, Greven MA. The development and spontaneous resolution of a full-thickness macular hole in bartonella henselae neuroretinitis in a 12-year-old boy. Am J Ophthalmol Case Rep 2019; 15:100515. [PMID: 31341998 PMCID: PMC6630014 DOI: 10.1016/j.ajoc.2019.100515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 05/16/2019] [Accepted: 07/08/2019] [Indexed: 11/04/2022] Open
Abstract
Purpose To describe an unusual case of Bartonella henselae neuroretinitis complicated by macular hole (MH) development. Observations A full-thickness macular hole developed in a 12-year-old boy in association with serology-confirmed Bartonella henselae neuroretinitis. Following a period of observation, the MH closed without intervention. Conclusion and importance MH may occur as a complication of neuroretinitis secondary to Cat-Scratch Disease.
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Affiliation(s)
- Robert C Gunzenhauser
- Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | | | - Margaret A Greven
- Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Nassif DS. Acute Unilateral Vision Loss in a Female Adolescent Due to Ocular Bartonellosis. Pediatr Emerg Care 2019; 35:e65-e66. [PMID: 28398939 DOI: 10.1097/pec.0000000000001135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Acute worsening of visual acuity with optic disc edema is commonly assumed to be due to idiopathic intracranial hypertension. Bartonella henselae is an unusual cause to abrupt vision loss that is associated with optic disc edema and exudative macular stars seen on examination. It is an important cause to be aware of because it responds very well to antibiotic treatment. We present a case of a female adolescent with unilateral vision loss cause by cat-scratch neuroretinitis.
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Affiliation(s)
- Douglas S Nassif
- From the Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI
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Domínguez I, Cartes C, Sabat P, Ortiz O, Matus G, Traipe L. Isolated conjunctival granuloma as a first manifestation of Parinaud's oculoglandular syndrome: A case report. Am J Ophthalmol Case Rep 2019; 14:58-60. [PMID: 30886938 PMCID: PMC6402948 DOI: 10.1016/j.ajoc.2019.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/29/2019] [Accepted: 02/19/2019] [Indexed: 12/01/2022] Open
Abstract
Purpose Parinaud's oculo-glandular syndrome (POGS) is the most frequent manifestation of ocular bartonellosis, and usually presents with local lymphadenopathies and systemic symptoms. We present a case of isolated conjunctival granuloma as the sole manifestation of ocular bartonellosis. Observations A 67-year-old female presented to the authors’ eye clinic with complaints of a 2-week history of unilateral red eye and chemosis. Slit lamp examination revealed an isolated bulbar conjunctival granuloma. The remainder of the eye examination was unremarkable. Topical treatment with gatifloxacin and prednisolone acetate was started. Etiological work-up was performed. General laboratory tests revealed only a mild leukocytosis, and interferon gamma-release assay and chest computed tomography were normal. Serological testing for Bartonella henselae was positive at titers of 1:1024. Three weeks after initial symptoms, lymphadenopathies, malaise, and fever appeared. Systemic azithromycin was added, which resulted in complete regression of the disease. Conclusion and importance Conjunctival granulomas present a wide range of differential diagnoses to the practitioner. Ocular bartonellosis is a relevant cause of conjunctival granuloma. POGS should be suspected in cases of conjunctival granulomata non-responsive to local therapy. It is important to consider that other agents to treat POGS have been described and are available, and that appropriate serological tests should be performed.
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Affiliation(s)
| | - Cristian Cartes
- Centro de la Visión Filial Clínica las Condes, Santiago, Chile
| | - Pablo Sabat
- Centro de la Visión Filial Clínica las Condes, Santiago, Chile
| | - Oscar Ortiz
- Centro de la Visión Filial Clínica las Condes, Santiago, Chile
| | - Gonzalo Matus
- Centro de la Visión Filial Clínica las Condes, Santiago, Chile
| | - Leonidas Traipe
- Centro de la Visión Filial Clínica las Condes, Santiago, Chile
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37
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Bartonellenneuroretinitis. Ophthalmologe 2019; 116:51-57. [DOI: 10.1007/s00347-018-0699-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Celiker H, Kazokoglu H, Eraslan M, Cerman E, Karabas L. Bartonella henselae Neuroretinitis in Patients without Cat Scratch. Jpn J Infect Dis 2018; 71:397-401. [PMID: 29962482 DOI: 10.7883/yoken.jjid.2017.518] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cat scratch disease (CSD) is a syndrome characterized by lymphadenopathy, fever, and skin lesions following a cat scratch or bite. Bartonella henselae is the primary bacterial agent responsible for CSD. In this report, we describe cases with atypical presentation of serologically proven B. henselae neuroretinitis. In this study, 3 patients with neuroretinitis were evaluated. Animal contact histories; results of ocular examinations and systemic investigations; clinical findings; and treatment compliance of the patients were assessed. All patients denied history of contact with cats or other animals, and they did not have CSD findings. Serologic testing via indirect immunofluorescence assay (IFA) was used to diagnose Bartonella neuroretinitis. The IFA test results were positive for all patients. Two patients were treated with antibiotics. Optic disc edema and macular exudates resolved gradually, and at their last follow-up visits, all signs had disappeared. There was no disease recurrence after the completion of treatment. Serious complications were seen in the untreated patient. In conclusion, B. henselae infection should be considered even when there are no systemic signs and symptoms of CSD in patients with neuroretinitis.
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Affiliation(s)
- Hande Celiker
- Department of Ophthalmology, Marmara University School of Medicine
| | - Haluk Kazokoglu
- Department of Ophthalmology, Marmara University School of Medicine
| | - Muhsin Eraslan
- Department of Ophthalmology, Marmara University School of Medicine
| | - Eren Cerman
- Department of Ophthalmology, Marmara University School of Medicine
| | - Levent Karabas
- Department of Ophthalmology, Kocaeli University School of Medicine
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Habot-Wilner Z, Trivizki O, Goldstein M, Kesler A, Shulman S, Horowitz J, Amer R, David R, Ben-Arie-Weintrob Y, Bakshi E, Almog Y, Sartani G, Vishnevskia-Dai V, Kramer M, Bar A, Kehat R, Ephros M, Giladi M. Cat-scratch disease: ocular manifestations and treatment outcome. Acta Ophthalmol 2018; 96:e524-e532. [PMID: 29504674 DOI: 10.1111/aos.13684] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 11/26/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE To characterize cat-scratch disease (CSD) ocular manifestations and visual outcome and evaluate the effect of systemic antibiotics and corticosteroids on final visual acuity (VA). METHODS Multicentre retrospective cohort study. Medical records of 86 patients with ocular disease (107 eyes) of 3222 patients identified in a national CSD surveillance study were reviewed. RESULTS Mean age was 35.1 ± 14.2 years. Median follow-up was 20 weeks (range 1-806 weeks). Of 94/107 (88%) eyes with swollen disc, 60 (64%) had neuroretinitis at presentation, 14 (15%) developed neuroretinitis during follow-up, and 20 (21%) were diagnosed with inflammatory disc oedema. Optic nerve head lesion, uveitis, optic neuropathy and retinal vessel occlusion were found in 43 (40%), 38 (36%), 34 (33%) and 8 (7%) eyes, respectively. Good VA (better than 20/40), moderate vision loss (20/40-20/200) and severe vision loss (worse than 20/200) were found in 26/79 (33%), 35/79 (44%) and 18/79 (23%) eyes at baseline and in 63/79 (80%), 11/79 (14%) and 5/79 (6%) eyes at final follow-up, respectively (p < 0.001). Significant VA improvement (defined as improvement of ≥3 Snellen lines at final follow-up compared to baseline) occurred in 12/24 (50%) eyes treated with antibiotics compared with 14/16 (88%) eyes treated with antibiotics and corticosteroids (p = 0.02). Multivariate logistic regression was suggestive of the same association (odds ratio 7.0; 95% CI 1.3-37.7; p = 0.024). CONCLUSION Optic nerve head lesion is a common and unique manifestation of ocular CSD. Most patients improved and had final good VA. Combined antibiotics and corticosteroid treatment was associated with a better visual outcome.
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Affiliation(s)
- Zohar Habot-Wilner
- Division of Ophthalmology; Tel Aviv Sourasky Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Omer Trivizki
- Division of Ophthalmology; Tel Aviv Sourasky Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Michaella Goldstein
- Division of Ophthalmology; Tel Aviv Sourasky Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Anat Kesler
- Division of Ophthalmology; Tel Aviv Sourasky Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Shiri Shulman
- Division of Ophthalmology; Tel Aviv Sourasky Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Josepha Horowitz
- Department of Ophthalmology; Carmel Medical Center; The Ruth and Bruce Rappaport Faculty of Medicine; Technion; Israel Institute of Technology; Haifa Israel
| | - Radgonde Amer
- Department of Ophthalmology; Hadassah Medical Center; The Hebrew University Hadassah Medical School; Jerusalem Israel
| | - Ran David
- Department of Ophthalmology; Hadassah Medical Center; The Hebrew University Hadassah Medical School; Jerusalem Israel
| | - Yael Ben-Arie-Weintrob
- Department of Ophthalmology; Rambam Medical Center; The Ruth and Bruce Rappaport Faculty of Medicine; Technion; Israel Institute of Technology; Haifa Israel
| | - Erez Bakshi
- Department of Ophthalmology; Assaf Harofeh Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Yehoshua Almog
- Department of Ophthalmology; Meir Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Gil Sartani
- Department of Ophthalmology; Haemek Medical Center; The Ruth and Bruce Rappaport Faculty of Medicine; Technion; Israel Institute of Technology; Haifa Israel
| | - Vicktoria Vishnevskia-Dai
- The Goldschleger Eye Institute; Department of Ophthalmology; Sheba Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Michal Kramer
- Division of Ophthalmology; Rabin Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Asaf Bar
- Department of Ophthalmology; Wolfson Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Rinat Kehat
- Department of Ophthalmology; Bnai Zion Medical Center; The Ruth and Bruce Rappaport Faculty of Medicine; Technion; Israel Institute of Technology; Haifa Israel
| | - Moshe Ephros
- Pediatric Infectious Disease Unit; Carmel Medical Center; The Ruth and Bruce Rappaport Faculty of Medicine; Technion; Israel Institute of Technology; Haifa Israel
| | - Michael Giladi
- Infectious Disease Unit and The Bernard Pridan Laboratory for Molecular Biology of Infectious Diseases; Tel Aviv Sourasky Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
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Urbina Soto L, López de Eguileta Rodríguez A, Echevarria Vierna S. A young woman with fever and low visual acuity. Eur J Intern Med 2018; 47:e3-e4. [PMID: 28506811 DOI: 10.1016/j.ejim.2017.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 04/30/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Leticia Urbina Soto
- Department of Internal Medicine, Marques de Valdecilla University Hospital, Santander, Cantabria, Spain.
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Abstract
PURPOSE The study reports an unusual presentation of a young female patient presenting with a granulomatous posterior pole mass and profound vision loss secondary to infection with Bartonella henselae. METHODS A single case report in a child. RESULTS An 8-year-old female presented with a recent history of flu-like illness associated with profound vision loss, panuveitis and leukocoria in the left eye. She was found to have a posterior granulomatous mass associated with an exudative retinal detachment presumed as a toxocara granuloma. Magnetic Resonance Imaging ruled out retinoblastoma. Lab work done was negative for toxocariasis and positive for Bartonella henselae titers. She was treated for Cat Scratch Disease (CSD) with steroids and azithromycin. With treatment, the inflammation and exudative retinal detachment resolved, however, the patient had no improvement in visual acuity. CONCLUSIONS Young patients presenting with leukocoria need a full work up, which includes ruling out retinoblastoma. CSD can present as a granulomatous mass similar to toxocariasis, which can rarely lead to debilitating and irreversible vision loss.
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Gabrial M, Islam S, Schaefer J, Pihlblad M. Case 3: Painless Vision Loss in an Adolescent. Pediatr Rev 2017; 38:385-386. [PMID: 28765202 DOI: 10.1542/pir.2016-0207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Shamim Islam
- Division of Infectious Diseases, Women and Children's Hospital of Buffalo, Buffalo, NY
| | - Jamie Schaefer
- Department of Ophthalmology, Ross Eye Institute, Buffalo, NY
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BARTONELLA HENSELAE NEURORETINITIS ASSOCIATED WITH CENTRAL RETINAL VEIN OCCLUSION, CHOROIDAL ISCHEMIA, AND ISCHEMIC OPTIC NEUROPATHY. Retin Cases Brief Rep 2017; 14:23-26. [PMID: 28700390 DOI: 10.1097/icb.0000000000000612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE We describe a healthy 37-year-old man with Bartonella henselae (B. henselae) neuroretinitis with concurrent central retinal vein occlusion and ischemic optic neuropathy resulting in optic atrophy and choroidal ischemia. METHODS Case report. RESULTS A 37-year-old man presented with unilateral decreased vision and a fundus examination consistent with neuroretinitis. Further imaging review supported a concurrent diagnosis of central retinal vein occlusion. Although initially negative, repeat serological testing for B. henselae infection was positive. Multimodal imaging displayed severe outer retinal disruption, ischemic optic neuropathy, and choroidal ischemia. The patient demonstrated near complete resolution of fundus findings and restoration of outer retinal architecture. Residual findings included optic disk pallor and ischemic choroidopathy. DISCUSSION B. henselae neuroretinitis may be associated with concurrent retinal vascular occlusive disease and ischemic optic neuropathy. Central retinal vein occlusion and choroidal ischemia leading to optic nerve atrophy are additional sequelae further expanding the clinical spectrum of this entity.
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44
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Barros S, de Andrade GC, Cavalcanti C, Nascimento H. Cat Scratch Disease: Not a Benign Condition. Ocul Immunol Inflamm 2017; 26:1115-1122. [PMID: 28665750 DOI: 10.1080/09273948.2017.1327077] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Describe a case series of ocular Cat-scratch-disease (CSD) with vision-threatening findings and poor outcomes, indicating severity of disease. METHODS Retrospective case series from the Uveitis Department of São Paulo Federal University from 2011 to 2015. RESULTS In this period, six eyes of four patients had confirmed diagnosis of CSD. Two were male and two female. Mean age was 24.8 years old [7-45]. Two had bilateral disease. Visual acuity at presentation ranged from no light perception to 20/25. Three patients were treated with doxycycline and one with clarithromycin and prednisone. Visual outcome after treatment ranged from counting fingers to 20/20: 5/6 eyes had final visual acuity of less than 20/40 and 3/6 had final visual acuity equal or less than 20/400. CONCLUSION Although usually described as a benign disease with spontaneous resolution, CSD can present with atypical manifestations such as vascular angiomatous lesions, serous retinal detachment, and vascular occlusion syndromes, carrying a severe course and guarded prognosis.
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Affiliation(s)
- Sandra Barros
- a Ophthalmology Department , Hospital Garcia de Orta , Almada , Portugal
| | - Gabriel Costa de Andrade
- b Uveitis Clinic of the Ophthalmology and Visual Sciences Department, Universidade Federal de Sao Paulo Escola Paulista de Medicina , Sao Paulo , Brazil
| | - Cecilia Cavalcanti
- b Uveitis Clinic of the Ophthalmology and Visual Sciences Department, Universidade Federal de Sao Paulo Escola Paulista de Medicina , Sao Paulo , Brazil
| | - Heloisa Nascimento
- b Uveitis Clinic of the Ophthalmology and Visual Sciences Department, Universidade Federal de Sao Paulo Escola Paulista de Medicina , Sao Paulo , Brazil
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Clinical Profile and Visual Outcome of Ocular Bartonellosis in Malaysia. J Trop Med 2017; 2017:7946123. [PMID: 28265290 PMCID: PMC5318637 DOI: 10.1155/2017/7946123] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/20/2016] [Accepted: 01/10/2017] [Indexed: 12/13/2022] Open
Abstract
Background. Ocular bartonellosis can present in various ways, with variable visual outcome. There is limited data on ocular bartonellosis in Malaysia. Objective. We aim to describe the clinical presentation and visual outcome of ocular bartonellosis in Malaysia. Materials and Methods. This was a retrospective review of patients treated for ocular bartonellosis in two ophthalmology centers in Malaysia between January 2013 and December 2015. The diagnosis was based on clinical features, supported by a positive Bartonella spp. serology. Results. Of the 19 patients in our series, females were predominant (63.2%). The mean age was 29.3 years. The majority (63.2%) had unilateral involvement. Five patients (26.3%) had a history of contact with cats. Neuroretinitis was the most common presentation (62.5%). Azithromycin was the antibiotic of choice (42.1%). Concurrent systemic corticosteroids were used in approximately 60% of cases. The presenting visual acuity was worse than 6/18 in approximately 60% of eyes; on final review, 76.9% of eyes had a visual acuity better than 6/18. Conclusion. Ocular bartonellosis tends to present with neuroretinitis. Azithromycin is a viable option for treatment. Systemic corticosteroids may be considered in those with poor visual acuity on presentation.
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Hernández-Porto M, Sánchez Burgos R, Martínez de las Heras B, Rodriguez Luis JC. Conjuntivitis palpebral y adenopatía preauricular: síndrome oculoglandular de Parinaud. Enferm Infecc Microbiol Clin 2017; 35:122-124. [DOI: 10.1016/j.eimc.2015.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 04/26/2015] [Accepted: 04/30/2015] [Indexed: 11/28/2022]
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Seroprevalence of Bartonella Species in Patients with Ocular Inflammation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1020:33-42. [PMID: 28405890 DOI: 10.1007/5584_2017_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Bartonella species, vector-borne etiologic agents of many systemic or self-limited infections, are responsible for a widening spectrum of diseases in humans, including inflammatory conditions of the eye. The aim of this study was to determine whether there is any relationship between uveitis and the evidence of Bartonella spp. infection in the serum, ocular fluid, and cataract mass in patients with intraocular inflammation. Polymerase chain reaction (PCR)-based tests and DNA sequencing were performed on surgery-extracted specimens of intraocular fluid and lens mass of 33 patients. Sera from 51 patients and 101 control subjects were tested for the presence of specific antibodies against Bartonella spp. Neither IgM-class antibodies against Bartonella spp. nor Bartonella spp. DNA were detected. A specific IgG-class antibody was found in 33.3% of the patients with uveitis. The rate of positive Bartonella serology was higher among the uveitis patients than that in control subjects. This high rate may in part result from unrecognized indirect mechanisms rather than the immediate presence and multiplication of Bartonella spp. in the eyeball. Nonetheless we believe that screening for Bartonella spp. should become part of the diagnostic workup in uveitis.
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Brunt J, Guptill L, Kordick DL, Kudrak S, Lappin MR. American Association of Feline Practitioners 2006 Panel report on diagnosis, treatment, and prevention of Bartonella spp. infections. J Feline Med Surg 2016; 8:213-26. [PMID: 16846781 DOI: 10.1016/j.jfms.2006.05.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2006] [Indexed: 11/18/2022]
Affiliation(s)
- Jane Brunt
- Cat Hospital At Towson (CHAT), 6701 York Road, Baltimore, MD 21212, USA
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Sridhar J, Khan MA. Woman With Vision Loss in Left Eye. Ann Emerg Med 2016; 68:e61-2. [DOI: 10.1016/j.annemergmed.2016.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Indexed: 11/16/2022]
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Pichi F, Srivastava SK, Levinson A, Baynes KM, Traut C, Lowder CY. A Focal Chorioretinal
Bartonella
Lesion Analyzed by Optical Coherence Tomography Angiography. Ophthalmic Surg Lasers Imaging Retina 2016; 47:585-8. [DOI: 10.3928/23258160-20160601-12] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 03/25/2016] [Indexed: 11/20/2022]
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