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Ambika S, Lakshmi P. Infectious optic neuropathy (ION), how to recognise it and manage it. Eye (Lond) 2024:10.1038/s41433-024-03152-8. [PMID: 38831116 DOI: 10.1038/s41433-024-03152-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 05/10/2024] [Accepted: 05/22/2024] [Indexed: 06/05/2024] Open
Abstract
Optic neuropathy can be of infectious or non-infectious/idiopathic aetiology. Many infectious organisms can cause optic neuropathy that can be of varied presentation including papillitis, retrobulbar optic neuritis, neuroretinitis, and optic perineuritis. Detailed history, ocular, systemic/neurologic examination along with appropriate laboratory evaluation can help clinicians to identify the infectious agent causing optic neuropathy. In spite of recent advanced techniques in serological testing and molecular diagnostics like polymerase chain reaction (PCR), the identification of these pathogens is still a diagnostic challenge. It is ideal to have an infectious disease (ID) consultant in the management team, as most of these infections are multisystem involving diseases. Most infectious agents can be effectively treated with specific antibiotics, with or without corticosteroid therapy, but visual recovery is highly variable and depends entirely on early diagnosis of the causative agent. This review article will provide an overview of common pathogens involved in ION and will describe their management paradigms.
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Affiliation(s)
- Selvakumar Ambika
- Department of Neuro-Ophthalmology, Sankara Nethralaya - A Unit of Medical Research Foundation, 18 College Road, Nungambakkam, Chennai, 600 006, India.
| | - Padma Lakshmi
- Department of Neuro-Ophthalmology, Sankara Nethralaya - A Unit of Medical Research Foundation, 18 College Road, Nungambakkam, Chennai, 600 006, India
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2
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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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Clare G, Kempen JH, Pavésio C. Infectious eye disease in the 21st century-an overview. Eye (Lond) 2024:10.1038/s41433-024-02966-w. [PMID: 38355671 DOI: 10.1038/s41433-024-02966-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 01/10/2024] [Accepted: 01/26/2024] [Indexed: 02/16/2024] Open
Abstract
Infectious diseases affecting the eye often cause unilateral or asymmetric visual loss in children and people of working age. This group of conditions includes viral, bacterial, fungal and parasitic diseases, both common and rare presentations which, in aggregate, may account for a significant portion of the global visual burden. Diagnosis is frequently challenging even in specialist centres, and many disease presentations are highly regional. In an age of globalisation, an understanding of the various modes of transmission and the geographic distribution of infections can be instructive to clinicians. The impact of eye infections on global disability is currently not sufficiently captured in global prevalence studies on visual impairment and blindness, which focus on bilateral disease in the over-50s. Moreover, in many cases it is hard to differentiate between infectious and immune-mediated diseases. Since infectious eye diseases can be preventable and frequently affect younger people, we argue that in future prevalence studies they should be considered as a separate category, including estimates of disability-adjusted life years (DALY) as a measure of overall disease burden. Numbers of ocular infections are uniquely affected by outbreaks as well as endemic transmission, and their control frequently relies on collaborative partnerships that go well beyond the remit of ophthalmology, encompassing domains as various as vaccination, antibiotic development, individual healthcare, vector control, mass drug administration, food supplementation, environmental and food hygiene, epidemiological mapping, and many more. Moreover, the anticipated impacts of global warming, conflict, food poverty, urbanisation and environmental degradation are likely to magnify their importance. While remote telemedicine can be a useful aide in the diagnosis of these conditions in resource-poor areas, enhanced global reporting networks and artificial intelligence systems may ultimately be required for disease surveillance and monitoring.
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Affiliation(s)
| | - John H Kempen
- Department of Ophthalmology and Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary; and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Sight for Souls, Bellevue, WA, USA
- MCM Eye Unit; MyungSung Christian Medical Center (MCM) Comprehensive Specialized Hospital and MyungSung Medical College, Addis Ababa, Ethiopia
- Department of Ophthalmology, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia
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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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Etter EJ, Trivitt SJ, Bosse BL, McWilliams A. Abnormal Presentation of Bartonella henselae Encephalopathy in a Pediatric Patient. Cureus 2023; 15:e43535. [PMID: 37719525 PMCID: PMC10500953 DOI: 10.7759/cureus.43535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Cat scratch disease (CSD) is a zoonotic infection caused by the transmission of gram-negative bacteria Bartonella henselae through a scratch or bite of a feline carrying B. henselae-infected fleas. CSD often presents clinically as a self-limited flu-like infection with painful regional lymphadenopathy appearing one to two weeks following initial transmission. However, a growing body of literature highlights abnormal presentations of Bartonella infections within the pediatric population. In this case report, we describe an atypical presentation of a B. henselae infection in an 11-year-old female with seizures, prolonged encephalopathy, agitation, and truncal instability. With an atypical presentation, a delay in diagnosis can result in potentially permanent organ damage, particularly as traditional empiric antibiotics fail to cover Bartonella infections. As such, proper treatment and complete resolution of symptoms require astute clinical recognition to make the correct diagnosis promptly.
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Affiliation(s)
- Emily J Etter
- Pediatrics, University of Nevada, Reno School of Medicine, Reno, USA
| | - Spencer J Trivitt
- Pediatrics, University of Nevada, Reno School of Medicine, Reno, USA
| | - Benjamin L Bosse
- Radiology, University of Nevada, Reno School of Medicine, Reno, USA
| | - Alison McWilliams
- Pediatrics, University of Nevada, Reno School of Medicine, Reno, USA
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Jin X, Gou Y, Xin Y, Li J, Sun J, Li T, Feng J. Advancements in understanding the molecular and immune mechanisms of Bartonella pathogenicity. Front Microbiol 2023; 14:1196700. [PMID: 37362930 PMCID: PMC10288214 DOI: 10.3389/fmicb.2023.1196700] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Bartonellae are considered to be emerging opportunistic pathogens. The bacteria are transmitted by blood-sucking arthropods, and their hosts are a wide range of mammals including humans. After a protective barrier breach in mammals, Bartonella colonizes endothelial cells (ECs), enters the bloodstream, and infects erythrocytes. Current research primarily focuses on investigating the interaction between Bartonella and ECs and erythrocytes, with recent attention also paid to immune-related aspects. Various molecules related to Bartonella's pathogenicity have been identified. The present review aims to provide a comprehensive overview of the newly described molecular and immune responses associated with Bartonella's pathogenicity.
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Affiliation(s)
- Xiaoxia Jin
- Gansu Provincial Key Laboratory of Evidence Based Medicine and Clinical Translation and Lanzhou Center for Tuberculosis Research, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Yuze Gou
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou, China
| | - Yuxian Xin
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou, China
| | - Jingwei Li
- Gansu Provincial Key Laboratory of Evidence Based Medicine and Clinical Translation and Lanzhou Center for Tuberculosis Research, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Jingrong Sun
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou, China
| | - Tingting Li
- Gansu Provincial Key Laboratory of Evidence Based Medicine and Clinical Translation and Lanzhou Center for Tuberculosis Research, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Jie Feng
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou, China
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, Lanzhou, China
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7
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Rodriguez W, Fedorova M, Rukmangadachar L. From (Cat) Scratch: A Unique Presentation of Central Nervous System Bartonella Infection. Cureus 2023; 15:e37044. [PMID: 37153245 PMCID: PMC10154252 DOI: 10.7759/cureus.37044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2023] [Indexed: 04/05/2023] Open
Abstract
Central nervous system manifestations of Bartonella species are rare and include meningitis, neuroretinitis, encephalitis, and isolated optic neuritis. We present the case of a 28-year-old woman who presented with a four-month history of progressive, asymmetric, bilateral painless vision loss. Her past medical history was significant for systemic lupus erythematosus. Notably, she had been on a high dose of prednisone for her immunosuppressive regimen. Brain MRI showed numerous contrast-enhancing lesions scattered throughout bilateral cerebral and cerebellar hemispheres and brainstem. She underwent a brain biopsy, and infection with Bartonella henselae was confirmed via a polymerase chain reaction. The patient was started on doxycycline and rifampin with improvement in vision and resolution of lesions as confirmed by a follow-up brain MRI. The literature review did not reveal any cases of multiple brain abscesses due to central nervous system Bartonella. Our case report aims to promote consider Bartonella infection as a cause of multiple brain abscesses in immunocompromised patients. It is essential to note that Bartonella can imitate other central nervous system infections, including toxoplasmosis, cryptococcosis, cysticercosis, and tuberculomas. Early identification is crucial as prompt treatment can lead to a complete cure.
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Bellur S, Ali A, Nguyen NV, Fernandes JK, Kodati S. Central retinal vein occlusion associated with Bartonella henselae infection. J Ophthalmic Inflamm Infect 2023; 13:14. [PMID: 36977910 PMCID: PMC10050272 DOI: 10.1186/s12348-023-00334-5] [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: 02/09/2023] [Accepted: 03/02/2023] [Indexed: 03/30/2023] Open
Abstract
PURPOSE To report the clinical features and treatment course of a case of central retinal vein occlusion (CRVO) as the initial sign of ocular Bartonella henselae (B. henselae) infection. OBSERVATION A 36-year-old male was evaluated for unilateral vision loss. He denied prodromal symptoms but reported prior exposure to fleas. Best corrected visual acuity (BCVA) was 20/400 in the left eye. Clinical examination revealed a CRVO with atypical features including significant peripapillary exudates and peripheral vascular sheathing. Laboratory testing revealed elevated B. henselae IgG titers (1:512) with no abnormalities on hypercoagulability testing. The patient was treated with doxycycline and aflibercept with an excellent clinical response and improvement in BCVA to 20/25 in the left eye two months later. CONCLUSION CRVO is a rare but sight-threatening complication of ocular bartonellosis and can be the presenting sign of infection, even in the absence of cat exposure or prodromal symptoms.
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Affiliation(s)
- Sunil Bellur
- National Eye Institute, National Institutes of Health, 10 Center Dr, 10/10N248, Bethesda, Maryland, 20892, USA
| | - Amir Ali
- National Eye Institute, National Institutes of Health, 10 Center Dr, 10/10N248, Bethesda, Maryland, 20892, USA
- University of Texas Medical Branch, Galveston, Texas, USA
| | - Nam V Nguyen
- National Eye Institute, National Institutes of Health, 10 Center Dr, 10/10N248, Bethesda, Maryland, 20892, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | | | - Shilpa Kodati
- National Eye Institute, National Institutes of Health, 10 Center Dr, 10/10N248, Bethesda, Maryland, 20892, USA.
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Waseem R, Seher M, Ghazal S, Shah HH, Habiba U. Cat scratch disease in a 23-year-old male-Case report. Front Public Health 2023; 10:1046666. [PMID: 36711423 PMCID: PMC9880049 DOI: 10.3389/fpubh.2022.1046666] [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] [Received: 09/16/2022] [Accepted: 12/05/2022] [Indexed: 01/14/2023] Open
Abstract
Cat-scratch disease (CSD) is an infectious disease that usually presents with fever, headache, loss of appetite, weight loss, tender lymphadenopathy, and other symptoms. CSD is also the most common cause of infectious lymphadenitis in children, adolescents, and young adults. This contagious disease most often results from a scratch or bite of a cat. The course of this disease depends on the patient's immune status. CSD sometimes presents as a systemic disease and leads to various disease entities. In this study, we describe the case of a 23-year-old man exhibiting fever, generalized weakness, and neck swelling. The patient was unconscious when presented to the Emergency Department. He was given at least 3-4 liters IV bolus of 0.9% normal saline, but it failed to raise the blood pressure. He was then given an inotropic drug (noradrenaline) for low blood pressure and antibiotics (azithromycin) for fever. Venereal disease research laboratory (VDRL) and human immunodeficiency virus (HIV) serology came out negative. Histopathology ruled out tuberculosis and malignancy and confirmed necrotizing/suppurative granulomatous inflammation. These features favor the diagnosis of CSD.
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Limitations of Serological Diagnosis of Typical Cat Scratch Disease and Recommendations for the Diagnostic Procedure. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:4222511. [PMID: 36915870 PMCID: PMC10008113 DOI: 10.1155/2023/4222511] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/22/2023] [Accepted: 02/11/2023] [Indexed: 03/07/2023]
Abstract
Introduction Cat scratch disease (CSD) is the most common cause of bacterial infectious lymphadenopathy, especially in children, but its diagnosis still remains challenging. Serological assays are widely applied due to their simplicity and the non-invasive sampling. However, these techniques present several limitations, including not well-defined antigen preparation, assay conditions and cutoff titers, severe cross-reactions with other species and organisms, and the notably ranging seroprevalence in the normal population. The objective of this study is to review the literature in order to determine the best diagnostic procedure for the diagnosis of CSD. Methods Databases including PubMed, Medline, Google Scholar, and Google were searched to determine the best diagnostic procedure for the diagnosis of CSD. A total of 437 papers were identified and screened, and after exclusion of papers that did not fulfill the including criteria, 63 papers were used. Results It was revealed that sensitivities of serological assays varied from 10% to 100%. Indeed, more than half of the studies reported a sensitivity lower than 70%, while 71% of them had a sensitivity lower than 80%. Moreover, specificities of serological assays ranged from 15% to 100%, with 25 assays reporting a specificity lower than 90%. Conclusion It is considered that molecular assays should be the gold standard technique for CSD confirmation, and physicians are reinforced to proceed to lymph node biopsy in suspicious CSD cases.
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Muacevic A, Adler JR. Unilateral Focal Retinitis as an Initial Manifestation of Cat-Scratch Disease. Cureus 2022; 14:e30907. [PMCID: PMC9622414 DOI: 10.7759/cureus.30907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2022] [Indexed: 11/07/2022] Open
Abstract
We report on a case of focal retinitis as the initial manifestation of cat-scratch disease. A 56-year-old Hispanic woman presented for a routine follow-up examination. A fundus examination of the right eye revealed a white retinal lesion along the inferotemporal artery; this lesion was noted to have progressed after one week of observation. On further inquiry, the patient reported she had seven cats at home, some of which were less than six months old and had recently scratched her. She received empirical treatment for focal retinitis with azithromycin (500 mg daily) and valacyclovir (1 g three times daily), which would cover the most common parasitic, viral, and bacterial etiologies. She was lost to a follow-up examination. However, she continued the same dose of antibiotic and antiviral treatment. Upon her eventual follow-up, three months later, it was noted that the lesion had resolved. The initial work-up revealed that she was positive for Bartonella henselae IgM (1:20) and IgG (1:512), as well as for B. quintana IgG (1:256); however, she was negative for B.quintana IgM. At a four-month follow-up appointment, the B. henselae IgM was negative, the IgG had decreased from 1:512 to 1:64, and the B. quintana antibody test was negative for IgM and IgG, all of which are consistent with an adequately treated case of cat-scratch disease. Focal retinitis can be a rare initial manifestation of cat-scratch disease, which should be considered part of the differential diagnosis in cases of focal retinitis, especially in patients with a history of close contact with young cats. Additionally, oral azithromycin may be considered as a treatment for some cases of cat-scratch-associated focal retinitis.
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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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A Comprehensive Update on Retinal Vasculitis: Etiologies, Manifestations and Treatments. J Clin Med 2022; 11:jcm11092525. [PMID: 35566655 PMCID: PMC9101900 DOI: 10.3390/jcm11092525] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/24/2022] [Accepted: 04/27/2022] [Indexed: 12/18/2022] Open
Abstract
Retinal vasculitis is characterized by inflammatory involvement of retinal arterioles, venules and/or capillaries and can be associated with a myriad of systemic and ophthalmic diseases. In this review, we have comprehensively discussed the etiologies, clinical manifestations, and presentations of retinal vasculitis. We have also included newer advances in imaging in retinal vasculitis such as OCTA and widefield imaging.
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Pichi F, Curi ALL, Vasconcelos-Santos DV, Marchese A, Cicinelli MV, Miserocchi E, Schlaen A. Optical Coherence Tomography Findings in Infectious Posterior Uveitis. Ocul Immunol Inflamm 2022; 30:652-663. [PMID: 35226572 DOI: 10.1080/09273948.2022.2032197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe and illustrate the main optical coherence tomography (OCT) findings of infectious uveitis. METHODS Narrative review. RESULTS Posterior segment OCT in patients with infectious uveitis reveals posterior hyaloid face precipitates, superficial retinal precipitates and infiltrates, foveolitis, retinitis, neuro-retinitis, choroidal granulomas, and choroiditis as main imaging biomarkers. Some of these features are specific to the underlying causing etiology and may support the diagnosis and the initiation of treatment. Some OCT features disappear completely with resolution; some others are associated with irreversible retinal damage. CONCLUSIONS OCT identifies different features of infectious uveitis into the vitreous, the retina, and the choroid. OCT characteristics, combined with other multimodal imaging features, are helpful in the differential diagnosis of infectious uveitis, the early detection of complications, and the assessment of the response to therapy.
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Affiliation(s)
- Francesco Pichi
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.,Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - André Luiz Land Curi
- Research Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectious Diseases - Ini - Fiocruz, Rio de Janeiro, Brazil
| | - Daniel Vitor Vasconcelos-Santos
- Faculdade de Medicina, Departamento de Oftalmologia e Otorrinolaringologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alessandro Marchese
- Department of Ophthalmology, Irccs Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Maria Vittoria Cicinelli
- Department of Ophthalmology, Irccs Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Elisabetta Miserocchi
- Department of Ophthalmology, Irccs Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Ariel Schlaen
- Department of Ophthalmology, Hospital Universitario Austral, Derqui-Pilar, Argentina
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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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16
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Karti O, Ataş F, Saatci AO. Posterior Segment Manifestations of Cat-scratch Disease: A Mini-review of the Clinical and Multi-modal Imaging Features. Neuroophthalmology 2021; 45:361-371. [PMID: 34720266 DOI: 10.1080/01658107.2021.1939393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Bartonella henselae, an intracellular gram-negative bacillus, is usually transmitted from infected cats to humans by direct or indirect contact. The bacterium mainly infects erythrocytes and endothelial cells thereby leading to so called cat-scratch disease (CSD) and may present with various localised and/or systemic manifestations. The eye is the most commonly affected organ in disseminated CSD and ocular bartonellosis has been reported in 5-10% of CSD patients. The most well-known clinical feature of ocular bartonellosis is neuroretinitis but various sight-threatening posterior segment lesions involving the optic nerve, retinal vasculature, retinal and choroidal tissues may occur during the disease course. This mini-review aims to overview both the clinical and multi-modal imaging characteristics of posterior ocular segment manifestations of CSD.
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Affiliation(s)
- Omer Karti
- Department of Ophthalmology, Democracy University, İzmir, Turkey
| | - Ferdane Ataş
- Department of Ophthalmology, Dokuz Eylul University, İzmir, Turkey
| | - Ali Osman Saatci
- Department of Ophthalmology, Dokuz Eylul University, İzmir, Turkey
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17
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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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18
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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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19
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Cat Scratch Disease: The First Case Report in Republic of North Macedonia. ACTA ACUST UNITED AC 2020; 41:71-75. [PMID: 33500373 DOI: 10.2478/prilozi-2020-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cat scratch disease (CSD) is the main clinical manifestation caused by Bartonella henselae in immuno-competent patients. The bacterium is transmitted to humans from cats via scratches or bites. In this case report, we are presenting to our knowledge the first etiologically confirmed case of CSD in our country. Here we describe the case of a previously healthy adult female patient presenting with fever and axillar lymphadenopathy over 1-month period. She underwent numerous clinical and paraclinical investigations for potential etiologies associated with lymphadenopathy and fever. Finally, serological testing for B.henselae was performed with titers for IgG 1:1024 and 1:160 for IgM, which confirmed the diagnosis. Five-day treatment with azithromycin resulted with good clinical response and complete recovery. We proved that CSD is a reality in our country and this report should raise awareness in medical doctors, especially infectious disease specialist. Also, CSD should be included in differential diagnosis in patients with fever of unkown origin (FUO), who are presenting with regional lymphadenopathy, with or without history of cat contact.
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20
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Qozat I, Lepper S, Seitz B. [Binocular Asymmetric Manifestation of Cat-Scratch Disease Due to Bartonella Henselae Infection in an Immunosuppressed Patient]. Klin Monbl Augenheilkd 2020; 239:1136-1142. [PMID: 33242882 DOI: 10.1055/a-1229-4391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Ibrahim Qozat
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Sabine Lepper
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Berthold Seitz
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes, Homburg/Saar
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21
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Epidemiological of cat scratch disease among inpatients in the Spanish health system (1997-2015). Eur J Clin Microbiol Infect Dis 2020; 40:849-857. [PMID: 33118059 DOI: 10.1007/s10096-020-04087-0] [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: 08/25/2020] [Accepted: 10/23/2020] [Indexed: 10/23/2022]
Abstract
Cat scratch disease, whose causative agent is Bartonella henselae, is an anthropozoonosis with a worldwide distribution that causes significant public health problems. Although it is an endemic disease in Spain, the available data are very limited. The aim of our study was to describe cat scratch disease inpatients in the National Health System (NHS) of Spain. This was a retrospective descriptive study using the minimum basic data set (CMBD in Spanish) in patients admitted to hospitals of the NHS between 1997 and 2015 with a diagnosis of cat scratch disease (ICD-9: 078.3). We found 781 hospitalized patients diagnosed with cat scratch disease. The mean age (± SD) was 30.7 ± 25.3 years old. The male/female ratio was 1.1:1. The incidence rate over the study period was 0.93 (95% CI, 0.86-0.99) cases per million person-years. The incidence rate in men was 0.98 cases per million person-years and that in women was 0.88 cases per million person-years. The cases were more frequent from September to January. A total of 652 (83.5%) cases were urgent hospital admissions. The average hospital stay was 8.4 ± 8.9 days. The overall lethality rate of the cohort was 1.3%. We have demonstrated that CSD causes a substantial burden of disease in Spain, affecting both adult and pediatric patients with a stable incidence rate. Our data suggest that CSD is benign and self-limited, with low mortality, and its incidence is possibly underestimated. Finally, there is a need for a common national strategy for data collection, monitoring, and reporting, which would facilitate a more accurate picture and the design of more strategic control measures. Hospital discharge records (HDRs) could be a good database for the epidemiological analysis of the hospital management of CSD.
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22
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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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23
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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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24
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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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25
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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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26
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Testi I, Mahajan S, Agrawal R, Agarwal A, Marchese A, Curi A, Khairallah M, Leo YS, Nguyen QD, Gupta V. Management of Intraocular Infections in HIV. Ocul Immunol Inflamm 2020; 28:1099-1108. [PMID: 32162992 DOI: 10.1080/09273948.2020.1727533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose: Overview of treatment options for the most common intraocular opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS), including ocular syphilis, ocular tuberculosis, toxoplasmic chorioretinitis, and viral retinitis. Method: Narrative Review. Results: Despite the huge advances in the development of combined antiretroviral therapy (cART) for the management of patients with human immunodeficiency virus (HIV) infection, opportunistic infections still represent a significant diagnostic dilemma and cause of ocular morbidity in patients with HIV. Conclusion: Although the treatment of intraocular infections in patients with AIDS may be challenging, prompt assessment of the clinical features and appropriate aggressive management of the underlying etiology are critical to avoid life and vision threatening.
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Affiliation(s)
- Ilaria Testi
- Moorfields Eye Hospital, NHS Foundation Trust , London, UK
| | - Sarakshi Mahajan
- Byers Eye Institute, Stanford University , Palo Alto, California, USA
| | - Rupesh Agrawal
- Moorfields Eye Hospital, NHS Foundation Trust , London, UK.,National Healthcare Group Eye Institute, Tan Tock Seng Hospital , Singapore, Singapore.,Singapore Eye Research Institute , Singapore, Singapore
| | - Aniruddha Agarwal
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh, India
| | - Alessandro Marchese
- Department of Ophthalmology, Scientific Institute San Raffaele, University Vita-Salute San Raffaele , Milan, Italy
| | - Andre Curi
- Research Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectious Diseases, Oswaldo Cruz Foundation , Rio de Janeiro, Brazil
| | - Moncef Khairallah
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir, Tunisia
| | - Yee Sin Leo
- National Center for Infectious Disease, Tan Tock Seng Hospital , Singapore, Singapore
| | - Quan Dong Nguyen
- Byers Eye Institute, Stanford University , Palo Alto, California, USA
| | - Vishali Gupta
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh, India
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27
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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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28
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Jabbehdari S, Lakusta AR, Moss HE. Anterior Optic Neuropathy in a Patient With Cyclical Fevers. JAMA Ophthalmol 2020; 138:314-315. [PMID: 31944233 DOI: 10.1001/jamaophthalmol.2019.4987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Sayena Jabbehdari
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago
| | | | - Heather E Moss
- Department of Ophthalmology, Stanford University, Palo Alto, California.,Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, California
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29
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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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30
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Leite-Lima F, Fonseca FP, Gomez RS, Lehman LFC, de Castro WH, Campos FEB. A nodule in the temporomandibular joint area. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 130:4-9. [PMID: 32173388 DOI: 10.1016/j.oooo.2019.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/22/2019] [Accepted: 03/21/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Flávia Leite-Lima
- Department of Oral and & Maxillofacial Surgery, Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Wagner Henriques de Castro
- Department of Oral and & Maxillofacial Surgery, Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Felipe Eduardo Baires Campos
- Department of Oral and & Maxillofacial Surgery, Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Bartonella henselae- and quintana-associated uveitis: a case series and approach of a potentially severe disease with a broad spectrum of ocular manifestations. Int Ophthalmol 2019; 39:2505-2515. [PMID: 30852734 DOI: 10.1007/s10792-019-01096-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/01/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To evaluate the clinical manifestations of intraocular inflammation associated with Bartonella infection and describe the assessment and management of patients with cat-scratch disease (CSD). METHODS This is a retrospective review of the clinical records of patients diagnosed with Bartonella henselae and Bartonella quintana intraocular inflammation from 2011 to 2018 in the Department of Ocular Inflammations and Infections of the University Eye Clinic of Ioannina (Greece). An analysis of the current literature concerning Bartonella-related intraocular infections was also carried out. RESULTS This is a retrospective study of 13 patients (7 males and 6 females) with a mean age of 39.2 years that were diagnosed with unilateral intraocular inflammation, except one case with bilateral affection, attributed to Bartonella (either henselae or quintana). Twelve (12) patients (92.3%) had a positive history of traumatic cat contact. The main ocular clinical findings with regard to the type of uveitis included neuroretinitis in 5 eyes (38.5%), vasculitis in 3 eyes (23.1%), iridocyclitis in 2 eyes (15.4%), intermediate uveitis in 2 eyes (15.4%), posterior uveitis in 1 eye (7.7%), panuveitis in 2 eyes (15.4%), retinochoroiditis in 2 eyes (15.4%), vitritis in 1 eye (7.7%), peripheral choroidal granuloma in 1 eye (7.7%). Immunoglobulin (Ig) G was positive in all cases. All patients were treated with antibiotics (mainly rifampicin, doxycycline and azithromycin). The visual acuity was noted to be improved in all patients after treatment, but some of them experienced disturbing complications. CONCLUSION CSD may manifest with various ocular pathological findings. Taking into consideration the increasing frequency of infections by B. henselae and B. quintana, clinicians should always incorporate CSD in the differential diagnosis of such presentations of uveitis. Educating vulnerable groups (children, immunosuppressed, etc.) and also general population, the appropriate preventing measures can contribute in limiting the risk of infection.
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Abstract
PURPOSE OF REVIEW To review the systemic and ocular complications of Bartonella spp. infections specifically cat scratch disease, encompassing epidemiology, laboratory diagnostics, ophthalmic imagining, and treatment. RECENT FINDINGS Recent studies have shown that ocular manifestations occur in approximately 4.4% of cat scratch disease patients. The annual prevalence is lower than previously reported to be approximately 12 500 cases annually. Mainstay treatment continues to be oral antibiotics with and without corticosteroids and is dependent on associated systemic manifestations, age, and patient immune status. More recently anti-VEGF agents have been used for complications such as cystoid macular edema and choroidal neovascularization. SUMMARY Bartonella spp. infections continue to be a common cause uveitis with ophthalmic manifestations ranging from neuroretinits, vascular occlusions, to choroidal granulomas. Review of associated risk factors including contact with feline reservoirs will aid in recognition and diagnosis of this disease entity. Laboratory diagnostics continue to improve to help with the diagnosis of this entity.
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Chaudhry R, Kokkayil P, Ghosh A, Bahadur T, Kant K, Sagar T, Kabra SK, Lodha R, Dey AB, Menon V. Bartonella henselae infection in diverse clinical conditions in a tertiary care hospital in north India. Indian J Med Res 2018; 147:189-194. [PMID: 29806608 PMCID: PMC5991118 DOI: 10.4103/ijmr.ijmr_1932_16] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background & objectives: Bartonella henselae causes infections which closely resemble febrile illness and chronic diseases such as tuberculosis and haematological malignancies. There are not many studies on Bartonella infections from India. The present study was undertaken to diagnose B. henselae infection in diverse clinical conditions in a tertiary care hospital in north India. Methods: A total of 145 patients including those with fever and lymphadenopathy, infective endocarditis and neuroretinitis were enrolled in the study. Whole blood, serum and lymph node aspirate and valvular vegetations if available, were obtained. Samples were plated on chocolate agar and brain-heart infusion agar containing five per cent fresh rabbit blood and were incubated at 35°C for at least four weeks in five per cent CO2 with high humidity. Immunofluorescent antibody assay (IFA) was done for the detection of IgM antibodies in the serum using a commercial kit. Whole blood was used to perform polymerase chain reaction (PCR) for the citrate synthase gene (gltA). Results: IFA was positive in 11 of 140 (7.85%) patients and PCR was positive in 3 of 140 (2.14%) patients. Culture was negative in all the cases. A higher incidence of Bartonella infection was seen in patients with fever and lymphadenopathy (n=30), seven of whom were children. In ophthalmological conditions, four cases were IFA positive. Interpretation & conclusions: The present study shows that the threat of Bartonella infection is a reality in India. It is also an important treatable cause of fever and lymphadenopathy in children. Serology and PCR are useful tests for its diagnosis. Clinicians should consider Bartonella infection in the differential diagnosis of febrile illnesses and chronic diseases.
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Affiliation(s)
- Rama Chaudhry
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Arnab Ghosh
- Department of Microbiology, Chacha Nehru Bal Chikitsalaya, New Delhi, India
| | - Tej Bahadur
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Kamala Kant
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Tanu Sagar
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Sunil Kumar Kabra
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Lodha
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Aparajit Ballav Dey
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vimala Menon
- Department of Ophthalmology, All India Institute of Medical Sciences, New Delhi, India
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Espí Rito Santo R, Salgado C, Prata F, Mouzinho A. Ptosis, miosis and cats. BMJ Case Rep 2017; 2017:bcr-2017-219673. [PMID: 28839109 DOI: 10.1136/bcr-2017-219673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Horner's syndrome (HS) is caused by a disruption in the oculosympathetic pathway. Both congenital and acquired HS are unusual in children. Acquired HS can be caused by trauma, surgical intervention, tumours, vascular malformations or infection.We describe the case of a 6-year-old boy who was brought to our emergency department with ptosis, miosis, painful cervical lymphadenopathy and a cat scratch on a hand. The diagnosis of a cat scratch disease was confirmed by serology. A full recovery was observed on antibiotic treatment and cervical lymphadenomegaly reduction 3 weeks later.
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Affiliation(s)
- Rita Espí Rito Santo
- Departamento de Pediatria, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - Catarina Salgado
- Departamento de Pediatria, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - Filipa Prata
- Departamento de Pediatria, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - Ana Mouzinho
- Departamento de Pediatria, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
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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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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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Parinaud's oculoglandular syndrome: A case report. ACTA ACUST UNITED AC 2016; 92:37-39. [PMID: 26996048 DOI: 10.1016/j.oftal.2016.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 02/06/2016] [Accepted: 02/08/2016] [Indexed: 11/21/2022]
Abstract
CLINICAL CASE A 33-year old woman presents with unilateral granulomatous conjunctivitis, ipsilateral regional lymphadenopathy and fever. A Bartonella henselae infection is demonstrated by indirect immunofluorescence, and a diagnosis of a Parinaud's oculoglandular syndrome is established. Outcome after treatment with oral doxycycline is satisfactory. DISCUSSION Parinaud's oculoglandular syndrome is the most frequent ocular manifestation of a Bartonella henselae infection.
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Juan Zepeda T, Jorge Morales S, Hugo Letelier A, Luis Delpiano M. [Bartonella henselae vertebral osteomyelitis: report of a case]. ACTA ACUST UNITED AC 2015; 87:53-8. [PMID: 26460082 DOI: 10.1016/j.rchipe.2015.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/15/2015] [Accepted: 08/24/2015] [Indexed: 11/17/2022]
Abstract
UNLABELLED Cat scratch disease (CSD) is caused by Bartonella henselae, with unknown prevalence and incidence in the Chilean paediatric population. Regional lymphadenopathy is the most common presentation, while atypical forms constitute a diagnostic challenge. OBJECTIVE To report a case of CSD with osteomyelitis and present guidelines regarding treatment. CLINICAL CASE An eight year-old patient, with prolonged febrile illness, back pain and neck stiffness. Laboratory studies highlight positive IgG for Bartonella henselae. The abdominal ultrasound showed splenic micro-abscesses, and the MRI showing vertebral lesions suggestive of osteomyelitis. DISCUSSION The diagnosis of atypical forms requires a high rate of suspicion, as in this case, in which the patient manifested the musculoskeletal symptoms simultaneously with the febrile syndrome, which led us to study possible complications of the disease. Current knowledge of the treatment of atypical or complicated CSD is derived from the observation of case studies, rather than randomized trials. It is suggested that antibiotic therapy is analysed individually, with the help of a specialist. CONCLUSION The importance of high clinical suspicion are emphasised and discussed, as well presenting some treatment options based on the evidence from the current literature.
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Affiliation(s)
- T Juan Zepeda
- Programa de Especialización en Pediatría, Universidad de Chile, Hospital San Borja Arriarán, Santiago Chile, Chile.
| | - S Jorge Morales
- Interno de Medicina, Universidad Católica del Maule, Talca, Chile
| | | | - M Luis Delpiano
- Servicio de Pediatría, Hospital San Borja Arriarán, Santiago, Chile
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Kahloun R, Abroug N, Ksiaa I, Mahmoud A, Zeghidi H, Zaouali S, Khairallah M. Infectious optic neuropathies: a clinical update. Eye Brain 2015; 7:59-81. [PMID: 28539795 PMCID: PMC5398737 DOI: 10.2147/eb.s69173] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Different forms of optic neuropathy causing visual impairment of varying severity have been reported in association with a wide variety of infectious agents. Proper clinical diagnosis of any of these infectious conditions is based on epidemiological data, history, systemic symptoms and signs, and the pattern of ocular findings. Diagnosis is confirmed by serologic testing and polymerase chain reaction in selected cases. Treatment of infectious optic neuropathies involves the use of specific anti-infectious drugs and corticosteroids to suppress the associated inflammatory reaction. The visual prognosis is generally good, but persistent severe vision loss with optic atrophy can occur. This review presents optic neuropathies caused by specific viral, bacterial, parasitic, and fungal diseases.
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Affiliation(s)
- Rim Kahloun
- 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
| | - Imen Ksiaa
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Anis Mahmoud
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Hatem Zeghidi
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Sonia Zaouali
- 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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Abstract
PURPOSE To review current literature on Coats disease and provide a structured framework for differentiating challenging clinical features in Coats disease patients. METHODS We critically reappraise historical and current literature and present clinical methods for developing a thorough differential diagnosis and management strategy for Coats disease. RESULTS Coats disease is a sporadic, usually unilateral condition typically occurring in young males. When untreated, this disorder can lead to total exudative retinal detachment and secondary glaucoma. CONCLUSIONS Anti-VEGF agents are currently a treatment option in combination with ablative therapy of telangiectatic vessels. Anti-VEGF agents appear particularly useful for patients with extensive areas of exudative retinal detachment, and are an effective treatment option for total retinal detachment.
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Lee RA, Ray M, Kasuga DT, Kumar V, Witherspoon CD, Baddley JW. Ocular bartonellosis in transplant recipients: two case reports and review of the literature. Transpl Infect Dis 2015; 17:723-7. [PMID: 26146758 DOI: 10.1111/tid.12418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 04/20/2015] [Accepted: 06/28/2015] [Indexed: 11/27/2022]
Abstract
Cat scratch disease is caused by Bartonella henselae and usually manifests as localized lymphadenopathy and fever in immunocompetent patients. Immunocompromised patients are at risk for developing disseminated disease affecting the liver, spleen, eyes, central nervous system, and other organs. Bartonellosis is infrequently reported in solid organ transplant recipients, and published case reports usually discuss disseminated infection. Localized ocular disease with B. henselae, while well documented in immunocompetent hosts, is uncommon in immunocompromised patients. Herein, we present 2 cases of ocular bartonellosis in renal transplant patients, 1 with disseminated infection, and 1 without.
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Affiliation(s)
- R A Lee
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - M Ray
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - D T Kasuga
- Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - V Kumar
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - C D Witherspoon
- Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - J W Baddley
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA
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Macías A, Aguirre C, Bustamante A, Garcés C, Echeverri V, Díaz A. Cat scratch disease in Medellín, Colombia. Oxf Med Case Reports 2015; 2014:43-5. [PMID: 25988023 PMCID: PMC4369997 DOI: 10.1093/omcr/omu018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 04/27/2014] [Accepted: 05/01/2014] [Indexed: 01/26/2023] Open
Abstract
Cat scratch disease (CSD) is the most common zoonosis transmitted by household animals. There is limited data on the epidemiology and clinical presentation of this disease in Colombia. The typical presentation includes subacute or chronic lymph node infection following inoculation of Bartonella henselae bacilli through a cat scratch. Cats have a B. henselae seroprevalence as high as 90%. Here, we report the case of a preschool boy from a rural area of Antioquia, Colombia, who presented with chronic lymphadenopathy in the right axilla. Other important infectious etiologies were ruled out, and confirmation was made with the Warthin Starry stain of a lymph node biopsy. We also discuss the most important aspects of the diagnosis, treatment and prevention of the disease.
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Affiliation(s)
| | - Carlos Aguirre
- Pediatrics Department, School of Medicine , Universidad de Antioquia , Medellín , Colombia
| | - Alberto Bustamante
- Pediatrics Department, School of Medicine , Universidad de Antioquia , Medellín , Colombia
| | - Carlos Garcés
- Pediatrics Department, School of Medicine , Universidad de Antioquia , Medellín , Colombia
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Galvez-Ruiz A. Macular star formation in diabetic patients with non-arteritic anterior ischemic optic neuropathy (NA-AION). Saudi J Ophthalmol 2015; 29:71-5. [PMID: 25859144 DOI: 10.1016/j.sjopt.2014.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 07/07/2014] [Accepted: 09/07/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND NA-AION is a condition that exhibits a number of unique characteristics in diabetics compared with the rest of the population. In some diabetic patients with NA-AION, lipid deposits can be observed around the macula forming an incomplete macular star. METHODS We describe 12 case studies of patients with NA-AION observing the development of lipid deposits around the macula forming an incomplete macular star. RESULTS All our patients developed some level of lipid deposits around the macula in the form of a macular hemistar in the course of their illness. CONCLUSION Some authors have suggested that the macular star is formed by transudation from capillaries deep in the optic disk through the intermediary tissue of Kuhnt, which is located between the retina and the anterior portion of the lamina retinalis. However, the development of the macular star is currently understood not as a simple transudation but as a multifactorial process involving the presence of vascular damage around the optic disk, which is considered one of the most important factors leading to its occurrence. Although some studies mention the presence of a macular star in patients with NA-AION, we believe that this phenomenon may be significantly more common than the current literature suggests.
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Affiliation(s)
- Alberto Galvez-Ruiz
- Neuro-ophthalmology Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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