A serologically proven case of cat-scratch disease presenting with neuroretinitis

Benjamin CY Chu, Victor TY Tam
Caritas Medical Centre, Shamshuipo, Kowloon, Hong Kong

Cat-scratch disease is a clinical syndrome that usually presents as a self-limiting illness featuring regional lymphadenopathy, fever, and small skin lesions in association with a cat scratch or bite. It is caused by the Gram-negative bacillus Bartonella henselae, which commonly affects children and young adults. Ocular bartonellosis is the most common atypical manifestation of cat-scratch disease. It can present with a wide spectrum of ocular diseases including neuroretinitis, Parinaud's oculoglandular syndrome, and other forms of intra-ocular inflammation. This case report describes cat-scratch disease neuroretinitis in a 10-year-old girl who presented with typical signs, including optic disc swelling and a macular star, preceded by pyrexia of unknown origin and cervical lymphadenopathy.

Hong Kong Med J 2009;15:391-3

Key words: Bartonella henselae; Cat-scratch disease; Eye infections, bacterial; Optic neuritis