Bartonella henselae infection presenting as a unilateral acute maculopathy.
BACKGROUND
The purpose of this article is to report an unusual ocular manifestation of cat scratch disease (CSD) presenting as a unilateral acute maculopathy (UAM). We describe and review the clinical, laboratory, fluorescein angiography (FA), indocyanine green angiography (ICG) and optical coherence tomography (OCT) records of a patient with CSD.


METHODS
A 30-year-old Chinese woman presented with a painless progressive visual loss affecting her left eye. Fundus examination of the left eye disclosed rare vitreous cells and a deep-creamy choroidal macular lesion with satellite foci of choroiditis.


RESULTS
FA revealed an early hypofluorescence of the lesion, becoming progressively hyperfluorescent with a leakage on the late phase. The ICG disclosed an early hypofluorescence of the macular lesion with a mild staining of its periphery on the late frames. Hypofluorescent satellite lesions were visible both on the early and late frames. The OCT disclosed a serous retinal detachment at the level of the whitish lesion. Serologies for Bartonella henselae (BH) became positive (IgG 1: 512, IgM < 1:20) confirming an active or recent infection.


CONCLUSIONS
Ocular manifestations of CSD can appear as a UAM with satellite lesions. CSD should be ruled out in patients manifesting such clinical features.
Wimmersberger
Y
Y
Clinique d'Ophtalmologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
Baglivo
E
E
D000208:Acute Disease; D000328:Adult; D018416:Bartonella henselae; D002372:Cat-Scratch Disease / Q000175:diagnosis*; D002833:Choroiditis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000175:diagnosis*