Bartonella henselae infection associated with peripapillary angioma, branch retinal artery occlusion, and severe vision loss

• Published in: American journal of ophthalmology 1999-02, Vol.127 (2), p.223-224
• Main Authors: Gray, Andrea V, Reed, J.Brian, Wendel, Robert T, Morse, Lawrence S
• Format: Article
• Language: English
• Subjects: Adult; Antibodies, Bacterial - analysis; Bacterial diseases; Bartonella henselae - immunology; Bartonellosis; Biological and medical sciences; Blindness - drug therapy; Blindness - microbiology; Blindness - pathology; Cat-Scratch Disease - drug therapy; Cat-Scratch Disease - microbiology; Cat-Scratch Disease - pathology; Defects; Doxycycline - therapeutic use; Drug Therapy, Combination - therapeutic use; Enzyme-Linked Immunosorbent Assay; Eye Infections, Bacterial - drug therapy; Eye Infections, Bacterial - microbiology; Eye Infections, Bacterial - pathology; Eyes & eyesight; Fluorescein Angiography; Fundus Oculi; Hemangioma, Capillary - drug therapy; Hemangioma, Capillary - microbiology; Hemangioma, Capillary - pathology; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Optic Neuritis - drug therapy; Optic Neuritis - microbiology; Optic Neuritis - pathology; Retinal Artery Occlusion - drug therapy; Retinal Artery Occlusion - microbiology; Retinal Artery Occlusion - pathology; Retinal Neoplasms - drug therapy; Retinal Neoplasms - microbiology; Retinal Neoplasms - pathology; Retinal Vessels - pathology; Retinitis - drug therapy; Retinitis - microbiology; Retinitis - pathology; Rifampin - therapeutic use; Tropical bacterial diseases; Tropical medicine; Veins & arteries; Visual Acuity
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/S0002-9394(98)00306-7

PURPOSE: To report atypical clinical features of Bartonella henselae neuroretinitis treated with combination antibiotics. METHOD: Case report. RESULTS: A 20-year-old man with a positive B. henselae titer developed a unilateral neuroretinitis, a large peripapillary angiomatous lesion, branch artery occlusion with ischemic maculopathy, and vision loss that failed to improve with clindamycin. Treatment with doxycycline and rifampin led to rapid clinical improvement. The severe vision loss in this case is atypical. CONCLUSIONS: Ocular findings associated with B. henselae infection may include retinal angiomatous lesion and branch retinal artery occlusion. Doxycycline and rifampin were successful in treating the infection.