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Jorge Orellana-Rios, Belinda Leong, Juan I Verdaguer-Diaz, K Bailey Freund; Expanding the Spectrum of Bartonella-Associated Neuroretinitis. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5369.
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To describe the occurrence of Bartonella-associated neuroretinitis secondary to non-feline pet exposure.
Medical records and imaging from 2 patients with confirmed Bartonella henselae (BH) neuroretinitis were retrospectively reviewed. Retinal imaging included color fundus photographs, optical coherence tomography (OCT), and fluorescein angiography (FA).
A 51-year-old woman presented with a central scotoma and decreased vision in her right eye (RE) for several days. She reported the onset of headache, malaise and inguinal lymphadenopathy 5 days after being scratched by her pet ferret (Mustela putorius furo). Clinical examination revealed disc edema and a macular star in the RE with subretinal fluid present on OCT B-scans. Best-corrected visual acuity (BCVA) was 20/30 in RE and 20/25 in the left eye (LE). Focal retinitis with overlying vitreous cells were present along retinal arcades in both eyes. Serology was positive for anti-BH (IgM titers 1:10, IgG titers 1:512). Following 6-weeks of oral Azithromycin 500 mg/daily, visual acuity improved to 20/20 in both eyes.A 19-year-old man reported 3 weeks of decreased of vision and central scotoma in his LE. Fever and preauricular lymphadenopathy were noted 1 week after manipulation of a pet guinea pig (Cavia porcellus). At presentation, BCVA in the RE was 20/20 and 20/200 in affected LE. Late disc leakage in the LE was identified on FA. Color fundus photographs of the LE showed a focal area of retinitis along the distal inferotemporal retinal arcade. Serology included high-titer anti-BH antibodies (IgG titers 1:1024). Complete resolution of disease was noted after 8-weeks of oral Doxycycline 200 mg/daily plus Rifampicin 600 mg/daily.
Humans may develop cat-scratch disease when they are exposed to BH in the saliva of infected cats or BH-containing flea feces reaching the systemic circulation through scratches or mucous membranes. As the cat flea (Ctenocephalides felis) may reside on non-feline animals, Bartonella-associated neuroretinitis may result from contact with other furred family pets.
This is a 2020 ARVO Annual Meeting abstract.
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