Neuroretinitis associated with cat-scratch disease: a case report

Abstract

U studenom 2003. godine u Centralnoj prijamnoj ambulanti Klinike za infektivne bolesti »Dr. Fran Mihaljević«, Zagreb liječena je bolesnica s vitritisom i stražnjim uveitisom oba oka te neuroretinitisom lijevog oka, nastalim tijekom bolesti mačjeg ogreba (BMO). Slabljenje vida nastalo je istovremeno s otokom limfnog čvora u aksili, tri tjedna nakon ogreba mačke. Nakon pregleda u jednoj zagrebačkoj klinici za očne bolesti, bolesnica je upućena u našu Kliniku radi etiološke dijagnostike i preporuke za antimikrobno liječenje. Idućeg dana hospitalizirana je na Klinici za očne bolesti. Za vrijeme hospitalizacije liječena je azitromicinom peroralno tijekom pet dana prema preporuci infektologa, uz lokalnu i parenteralnu terapiju kortikosteroidima. Bolest je imala povoljan ishod. Ovo je prvi slučaj neuroretinitisa nastalog tijekom BMO koji je dijagnosticiran u ovoj Klinici, u suradnji s oftalmolozima. Dijagnoza se temeljila na epidemiološkoj anamnezi, regionalnom limfadenitisu s odgovarajućim citološkim nalazom punktata i serološkoj potvrdi protutijela na Bartonellu henselae.In November 2003, a 32-year-old female patient with vitritis and uveitis (pars planitis) of both eyes and neuroretinitis of the left eye, associated with cat-scratch disease (CSD) was treated at the Central Admissions Department of the University Hospital for Infectious Diseases »Dr. Fran Mihaljevic«, Zagreb. Impaired vision occurred simultaneously with axillar lymph node swelling, three weeks after cat scratch. After the patient was examined at the Ophthalmology Clinic in Zagreb, she was referred to our Hospital for etiological diagnostics and recommendation for antimicrobial treatment. The following day the patient was hospitalized at the Ophthalmology Clinic. During hospitalization she was treated with azithromycin p.o. for five days according to recommendation by the infectious disease specialist, with local and parenteral corticosteroid therapy. The disease had favorable outcome. This is the first case of neuroretinitis associated with CSD that was diagnosed in our Hospital in collaboration with colleagues ophthalmologists. The diagnosis was based on epidemiological data, regional lymphadenitis with corresponding cytological finding and serological confirmation of antibodies to Bartonella henselae