A case of Bartonellosis mimicking systemic lupus erythematosus

Eur J Ophthalmol. 2023 Nov;33(6):NP41-NP48. doi: 10.1177/11206721221137163. Epub 2022 Nov 7.

Abstract

Background and aim: Cat-scratch disease (CSD) is a systemic bacterial infection caused by Bartonella henselae. The disease is typically characterized by regional lymphadenopathy developing after scratches from domestic or feral cats. Rarely, systemic involvement may be observed. The co-occurrence with glomerulonephritis and positive antinuclear antibody (ANA) tests have been reported before. In these cases, the disease can be misdiagnosed as systemic lupus erythematosus. Ocular involvement occurs in 5%-10% of the cases with CSD, and neuroretinitis is among the common manifestations. Administration of corticosteroids (CSs) in addition to antibiotics has been shown to improve prognosis in neuroretinitis cases. However, the optimal dose and duration, remain ill-defined.

Case report: In this article, we present an 11-year-old girl with CSD and neuroretinitis with a positive ANA test and hematuria, who benefited from high-dose methyl-prednisolone and antibiotics.

Conclusion: Further research is warranted in order to determine the dose and duration of CSs in the treatment of Bartonella neuroretinitis.

Keywords: Antinuclear antibody; Bartonella; systemic lupus erythematosus.