Cat scratch disease(CSD)is a worldwide distributed zoonosis caused by Bartonella henselae and other Bartonella spp.The reservoirs of Bartonella are domestic animals,especially cats,and the transmission to humans is th...Cat scratch disease(CSD)is a worldwide distributed zoonosis caused by Bartonella henselae and other Bartonella spp.The reservoirs of Bartonella are domestic animals,especially cats,and the transmission to humans is thought to occur from a cat scratch or even through the cat flea Ctenocephalides felix.With more and more pet owners,the physicians should keep in mind signs and symptoms of CSD.A widespread infection may occur in 5-14%of cases,and ocular involvement,called ocular bartonellosis,is a quite common consequence of disseminated CSD.Although the most typical manifestations of ocular Bartonellosis are Parinaud’s oculoglandular syndrome,neuroretinitis and retinochoroiditis,many other ophthalmic conditions have been reported.The diagnosis of CSD is often based on history of contact with a cat and high serum titers of immunoglobulin G antibodies against B.henselae.Polymerase chain reaction could be helpful for CSD diagnosis when serology is negative but clinical findings are suggestive for the disease.Multimodal imaging,including fundus autofluorescence,fluorescein and indocyanine green angiography,optical coherence tomography(OCT)and OCT angiography,can be used for diagnosis and monitoring of ocular Bartonellosis.Since CSD is more often a self-limited infection in immunocompetent individuals,no antibiotic treatment is usually needed.However,when a therapy is prescribed,doxycycline is the most used antibiotic.The aim of this article is to review the current literature relating to epidemiology,systemic and ocular manifestations,diagnosis,treatment and prognosis of bartonellosis,in order to give the ophthalmologists a useful tool for daily practice.展开更多
Neuroretinitis is characterized by optic disc swelling with macular star,and affects 1%-2%of the patients with Bartonella henselae infection.This condition needs to be considered in the differential diagnosis of unila...Neuroretinitis is characterized by optic disc swelling with macular star,and affects 1%-2%of the patients with Bartonella henselae infection.This condition needs to be considered in the differential diagnosis of unilateral optic neuropathy in young adults.A 44-year-old woman presented with a progressive visual loss in right eye that was described as a central scotoma with altered color perception.Medical history was negative except for Hashimoto's thyroiditis.The examination evidenced a relative afferent pupillary defect in right eye and marked papillary oedema involving the macular region.Brain and orbits magnetic resonance imaging were normal,and fundoscopy showed star-shaped hard exudates.Autoimmune and infective screening revealed IgM and IgG antibodies against Bartonella henselae,suggesting for recent cat-scratch disease.She was treated with high-dose intravenous steroids and doxycycline.One month later she fully recovered,and she had no relapses.We diagnosed a Bartonella henselae neuroretinitis(finally the patient recalled she had stroked stray cats,not being scratched).In conclusion time course and absence of pain differentiate neuroretinitis from other optic neuropathies.Fundoscopic image of macular star is a clue for diagnosis,and visual recovery is usually excellent.展开更多
文摘Cat scratch disease(CSD)is a worldwide distributed zoonosis caused by Bartonella henselae and other Bartonella spp.The reservoirs of Bartonella are domestic animals,especially cats,and the transmission to humans is thought to occur from a cat scratch or even through the cat flea Ctenocephalides felix.With more and more pet owners,the physicians should keep in mind signs and symptoms of CSD.A widespread infection may occur in 5-14%of cases,and ocular involvement,called ocular bartonellosis,is a quite common consequence of disseminated CSD.Although the most typical manifestations of ocular Bartonellosis are Parinaud’s oculoglandular syndrome,neuroretinitis and retinochoroiditis,many other ophthalmic conditions have been reported.The diagnosis of CSD is often based on history of contact with a cat and high serum titers of immunoglobulin G antibodies against B.henselae.Polymerase chain reaction could be helpful for CSD diagnosis when serology is negative but clinical findings are suggestive for the disease.Multimodal imaging,including fundus autofluorescence,fluorescein and indocyanine green angiography,optical coherence tomography(OCT)and OCT angiography,can be used for diagnosis and monitoring of ocular Bartonellosis.Since CSD is more often a self-limited infection in immunocompetent individuals,no antibiotic treatment is usually needed.However,when a therapy is prescribed,doxycycline is the most used antibiotic.The aim of this article is to review the current literature relating to epidemiology,systemic and ocular manifestations,diagnosis,treatment and prognosis of bartonellosis,in order to give the ophthalmologists a useful tool for daily practice.
文摘Neuroretinitis is characterized by optic disc swelling with macular star,and affects 1%-2%of the patients with Bartonella henselae infection.This condition needs to be considered in the differential diagnosis of unilateral optic neuropathy in young adults.A 44-year-old woman presented with a progressive visual loss in right eye that was described as a central scotoma with altered color perception.Medical history was negative except for Hashimoto's thyroiditis.The examination evidenced a relative afferent pupillary defect in right eye and marked papillary oedema involving the macular region.Brain and orbits magnetic resonance imaging were normal,and fundoscopy showed star-shaped hard exudates.Autoimmune and infective screening revealed IgM and IgG antibodies against Bartonella henselae,suggesting for recent cat-scratch disease.She was treated with high-dose intravenous steroids and doxycycline.One month later she fully recovered,and she had no relapses.We diagnosed a Bartonella henselae neuroretinitis(finally the patient recalled she had stroked stray cats,not being scratched).In conclusion time course and absence of pain differentiate neuroretinitis from other optic neuropathies.Fundoscopic image of macular star is a clue for diagnosis,and visual recovery is usually excellent.
