Cat-scratch Disease’s Ophthalmic

Cat-scratch disease is an infection of organism Bartonella Henselae bacteria. In the United States, about 22,000 new infections of cat-scratch disease are reported annually, usually caused by scratch or bite by cats. Clinically, official identification of the disease demands confirmation of three out of four of the following criteria:

  • Swollen or enlarged lymph nodes (Lymphadenopathy)
  • Confirmed cat interaction, preferably with blister or papule at contact point
  • Affirmative Bartonella H. skin or titer test
  • Presence of bacilli, and necrosis (premature death of cells) in lymph node biopsy

Bartonella is transmitted via the common flea, Ctenocephalides felis, to the cat, subsequently to the human host.

Slightly above 10% of cat-scratch disease patients may develop ophthalmic manifestations. They includes:

  • Neuroretinitis (inflammation of the neural retina and optic nerve)
  • Parinaud’s oculoglandular (pink eye) syndrome
  • Focal chorioretinitis (inflammation of retina and choroid)

 

  • Treatment is debated. It is widely attested that patients usually will improve in a timely manner. However, many reports support treatment may reduce recovery duration. Treatments usually include doxycycline, rifampin, erythromycin, ciprofloxacin, azithromycin, with steroid drop at the later stage.
    After full recovery from the disease, a patient may still experience residual vision field shortcoming, decreased contrast sensitiveness and vision acuteness, and discoloration of the sectoral disc on examination. Typically, lipid exudates in the form of a star is seen on the macular with a swollen optic disc. Eventually, the macular star will be resolved too.

 

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