Severe occlusive vasculitis as a complication of cat scratch disease.
BACKGROUND
The purpose of this communication is to report a severe occlusive vasculitis as a complication of cat scratch.


METHODS
A 34-year-old Hispanic woman presented with a sudden visual loss of the right eye associated with shivers, high fever and arthritis which developed 2 months after a cat's bite. Fundus examination showed papillitis and a palor of the paramacular zone of the retina. Fluorescein angiography revealed multiple arterial and venous vasculitic occlusions.


RESULTS
Auto-immune disease and endocarditis were ruled out by an extensive medical work-up. The diagnosis of Bartonella henselae was confirmed by a positive serology. A systemic antibiotherapy with azithromycin, doxycyclin, rifampicin and steroid therapy resulted in a good clinical response, including a rapid visual recovery with a visual acuity of 20/20 and no relapse of the disease at 6 months follow-up.


CONCLUSIONS
Ocular complications associated with cat scratch disease may include vasculitis with both arterial and venous occlusions causing severe visual loss.
Berguiga
M
M
Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland.
Abouzeid
H
H
Bart
P-A
PA
Guex-Crosier
Y
Y
D000328:Adult; D000818:Animals; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D001733:Bites and Stings / Q000150:complications* / Q000175:diagnosis*; D002372:Cat-Scratch Disease / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D002415:Cats; D005260:Female; D006801:Humans; D031300:Retinal Vasculitis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*