title: Cat-scratch disease: ocular manifestations and visual outcome.
abstract: To describe the intra-ocular manifestations of cat-scratch disease (CSD) found at two uveitis reference centers in Brazil. Retrospective case series study. Review of clinical records of patients diagnosed with CSD in the Uveitis Department of São Geraldo Hospital and the Ophthalmology Department of the Instituto de Pesquisa Clínica Evandro Chagas-FIOCRUZ, from 2001 to 2008. In the 8-year period, 24 patients with the diagnosis of CSD were identified. Twelve patients were male and 12 female. The mean age was 27.04 years (range 7-56). Sixteen patients (66.6%) presented with a history of a cat scratch and all patients reported cat exposure. Visual acuity ranged from counting fingers to 1.0 in the affected eye. Thirteen patients presented with bilateral disease. Sixteen (66.6%) patients complained of systemic symptoms, including fever, lymphadenopathy, liver and spleen enlargement and rash. All patients presented with serum antibodies (IgG) to Bartonella henselae. Thirty-seven eyes were affected. The most common findings were small areas of retinal infiltrates which occurred in 11 eyes (29.7%) and angiomatous lesions which occurred in nine eyes (24.3%). Neuroretinitis occurred in only six eyes (16.2%). The most common findings of CSD in our study were retinal infiltrates and angiomatous lesions. CSD patients may present with significant visual loss. Patients may benefit from systemic treatment with antibiotics.
authors.affiliation: Department of Ophthalmology, Instituto de Pesquisa Clinica Evandro Chagas, IPEC-FIOCRUZ, R. Francisco Dutra 150/801, Cep: 24220-150, Icaraí, Niterói, Rio de Janeiro, Brazil. andre.curi@ipec.fiocruz.br
authors.forename: André L L
authors.initials: AL
authors.lastname: Curi
authors.forename: Danuza
authors.initials: D
authors.lastname: Machado
authors.forename: Gustavo
authors.initials: G
authors.lastname: Heringer
authors.forename: Wesley Ribeiro
authors.initials: WR
authors.lastname: Campos
authors.forename: Cristiane
authors.initials: C
authors.lastname: Lamas
authors.forename: Tatiana
authors.initials: T
authors.lastname: Rozental
authors.forename: Alexandro
authors.initials: A
authors.lastname: Gutierres
authors.forename: Fernando
authors.initials: F
authors.lastname: Orefice
authors.forename: Elba
authors.initials: E
authors.lastname: Lemos
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D018416:Bartonella henselae; D002372:Cat-Scratch Disease / Q000150:complications / Q000175:diagnosis*; D002415:Cats; D002648:Child; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012173:Retinitis / Q000209:etiology / Q000382:microbiology; D014792:Visual Acuity; D055815:Young Adult