Neuroretinitis caused by Bartonella henselae in Gipuzkoa, 2014-2019

Abstract

Introduction: Bartonella henselae causes cat scratch disease (CSD), spread by a cat scratch or bite. Cats are its main reservoir. This sometimes results in optic neuritis or neuroretinitis.

Objective: To review these conditions in Gipuzkoa (Spain), 2014-2019.

Methods: A retrospective review of serology registries and clinical registries, selecting those with consistent clinical signs, contact with cats and positive serology for B. henselae (IgG-IFA ≥1/256).

Results: Sixty-four patients had CSD. Of these, one had optic neuritis and 3 had neuroretinitis (4/64; 6.3%). In 3 patients, flu-like symptoms preceded eye symptoms. Two suffered from loss of visual acuity at discharge, despite prolonged treatment with antibiotics and corticosteroids.

Conclusion: Optic neuritis and neuroretinitis caused by B. henselae are severe complications with a non-negligible incidence among patients with CSD in Gipuzkoa. We recommend ruling out CSD in patients with symptoms of optic neuritis or neuroretinitis (sudden vision loss, etc.) and contact with cats.

Keywords: Bartonella henselae; Cat scratch disease; Enfermedad por arañazo de gato; Neuroretinitis; Neurorretinitis.