An uncommon presentation of Bartonella-associated neuroretinitis.
BACKGROUND
This article documents a case of neuroretinitis initially presenting with ocular pain, 20/20 visual acuities, optic disc edema, and macular serous detachment without macular star formation in the absence of a history of exposure to pets or cats or symptoms suggestive of Bartonella infection. This initial clinical presentation appeared unilateral, but later became bilateral.


METHODS
Physical and neuroophthalmologic consultation, neuroimaging studies, blood chemistry, and serologic analysis were requested. Positive serologic (IGG) titers to Bartonella henselae and Bartonella quintana were detected. Treatment was instituted initially with oral tetracycline (250 mg) qid and subsequently with doxycycline (100 mg) bid and prednisone (20 mg) qd.


CONCLUSIONS
Bartonella infection may cause optic disc edema and serous detachment without macular star formation. This presentation may occur without the generally characteristic signs and symptoms of Bartonella-associated neuroretinitis. A bilateral involvement may follow an initial unilateral presentation during the affliction period of this disorder.
College of Optometry, NOVA Southeastern University, North Miami Beach, Florida 33162, USA. ebesada@nova.edu
Eulogio
E
Besada
Albert
A
Woods
Michelle
M
Caputo
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D001474:Bartonella Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D018416:Bartonella henselae / Q000276:immunology*; D018413:Bartonella quintana / Q000276:immunology*; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009898:Optic Disk / Q000000981:diagnostic imaging; D010211:Papilledema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D011241:Prednisone / Q000627:therapeutic use; D012163:Retinal Detachment / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D012173:Retinitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014463:Ultrasonography; D014792:Visual Acuity; D014794:Visual Fields
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D005938:Glucocorticoids; D004318:Doxycycline; D011241:Prednisone