Suspecting optic neuritis, diagnosing Bartonella cat scratch disease

Abstract

Background: Bartonella cat scratch disease is classically a febrile illness, in conjunction with lymphadenopathy and cat exposure.

Objective: To report 2 atypical cases of cat scratch disease with only blurred vision and headache.

Design: Case reports.

Setting: University hospital.

Patients: Two young adults with unilateral blurred vision, retro-orbital headache, and a positive Bartonella henselae serologic result, without fever or lymphadenopathy.

Main outcome measures: Funduscopic examination and B henselae serologic findings.

Results: Both patients had optic disc swelling and a macular star on funduscopic examination, suggestive of infection. Infection was confirmed by positive serologic results.

Conclusion: Cat scratch disease should be considered in the differential diagnosis for patients presenting with blurred vision and headache, even in the absence of fever, lymphadenopathy, or both.