Cat-scratch disease manifesting as uveitis and binocular fundus nodular lesions: a case report

BMC Ophthalmol. 2023 Aug 7;23(1):345. doi: 10.1186/s12886-023-03063-4.

Abstract

Background: Cat-scratch disease typically presents with various ocular manifestations such as uveitis, vitritis, retinitis, retinochoroiditis, and optic neuritis. However, fundus nodular lesions was rarely reported. In our study, we reported a case of Cat-Scratch disease with binocular fundus nodular lesions.

Case presentation: An 11-year old male presented with uveitis in the right eye and bilateral fundus nodular lesions after indirect contact with unvaccinated cats. Comprehensive ancillary examinations including wide-angle fundus photography, ultrasonography, fluorescein fundus angiography, optical coherence tomography, and orbital magnetic resonance imaging were performed to elucidate the multidimensional features of the binocular lesions. Metagenomics next-generation sequencing was utilized to confirm the diagnosis of Cat-scratch disease. The patient's condition showed improvement after a 6-month combination treatment regimen involving systemic administration of doxycycline hyclate and methylprednisolone tablets, as well as local application of mydriatic and corticosteroid eye drops.

Conclusions: We firstly reported a case of Cat-scratch disease presenting simultaneously with uveitis and fundus nodular lesions caused by Bartonella henselae infection in a child. Timely diagnosis and treatment with antibiotics and corticosteroids showed promising outcomes for the prognosis of these ocular disorders.

Keywords: Bartonella; Cat-scratch disease; Fundus; Metagenomics next-generation sequencing (mNGS); Ocular manifestations.

Publication types

  • Case Reports

MeSH terms

  • Bartonella henselae*
  • Cat-Scratch Disease* / diagnosis
  • Cat-Scratch Disease* / drug therapy
  • Chorioretinitis*
  • Fundus Oculi
  • Humans
  • Male
  • Retinitis* / diagnosis