Cat scratch disease: A case report

Abstract

Cat scratch disease, caused by Bartonella henselae, is a zoonotic infection that can rarely lead to severe ocular involvement. We report the case of a 27-year-old woman with no significant medical history who presented with a rapid decrease in visual acuity in the right eye following close contact with cats. Ophthalmologic examination revealed a visual acuity of 1/10 in the right eye and 9/10 in the left eye, with a star-shaped maculopathy and a superior paramacular retinal lesion. Optical coherence tomography (OCT) showed cystoid macular edema associated with serous retinal detachment, while fluorescein angiography revealed a late hyperfluorescent retinal focus with stellate exudates. Serology for Bartonella henselae was positive with high IgG titers, confirming the diagnosis. The patient was treated with doxycycline and rifampicin combined with a tapering oral corticosteroid regimen for six weeks, resulting in an improvement of visual acuity to 7/10 at 45 days of follow-up. This case highlights the importance of considering cat scratch disease in the differential diagnosis of macular and retinal lesions and demonstrates the effectiveness of combined antibiotic and corticosteroid therapy.