Cat Scratch Disease: Not a Benign Condition

Ocul Immunol Inflamm. 2018;26(7):1115-1122. doi: 10.1080/09273948.2017.1327077. Epub 2017 Jun 30.

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.

Keywords: Bartonella henselae; Cat-scratch disease; uveitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Antibodies, Bacterial / blood
  • Bartonella henselae / immunology
  • Bartonella henselae / isolation & purification*
  • Cat-Scratch Disease / diagnosis*
  • Cat-Scratch Disease / drug therapy
  • Cat-Scratch Disease / immunology
  • Child
  • Clarithromycin / therapeutic use
  • Doxycycline / therapeutic use
  • Eye Infections, Bacterial / diagnosis*
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / immunology
  • Female
  • Fluorescent Antibody Technique, Indirect
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Male
  • Middle Aged
  • Prednisone / therapeutic use
  • Retrospective Studies
  • Uveitis / diagnosis*
  • Uveitis / drug therapy
  • Uveitis / immunology
  • Visual Acuity

Substances

  • Anti-Bacterial Agents
  • Antibodies, Bacterial
  • Glucocorticoids
  • Immunoglobulin G
  • Immunoglobulin M
  • Clarithromycin
  • Doxycycline
  • Prednisone