Abstract
Purpose
To evaluate the clinical manifestations of intraocular inflammation associated with Bartonella infection and describe the assessment and management of patients with cat-scratch disease (CSD).
Methods
This is a retrospective review of the clinical records of patients diagnosed with Bartonella henselae and Bartonella quintana intraocular inflammation from 2011 to 2018 in the Department of Ocular Inflammations and Infections of the University Eye Clinic of Ioannina (Greece). An analysis of the current literature concerning Bartonella-related intraocular infections was also carried out.
Results
This is a retrospective study of 13 patients (7 males and 6 females) with a mean age of 39.2 years that were diagnosed with unilateral intraocular inflammation, except one case with bilateral affection, attributed to Bartonella (either henselae or quintana). Twelve (12) patients (92.3%) had a positive history of traumatic cat contact. The main ocular clinical findings with regard to the type of uveitis included neuroretinitis in 5 eyes (38.5%), vasculitis in 3 eyes (23.1%), iridocyclitis in 2 eyes (15.4%), intermediate uveitis in 2 eyes (15.4%), posterior uveitis in 1 eye (7.7%), panuveitis in 2 eyes (15.4%), retinochoroiditis in 2 eyes (15.4%), vitritis in 1 eye (7.7%), peripheral choroidal granuloma in 1 eye (7.7%). Immunoglobulin (Ig) G was positive in all cases. All patients were treated with antibiotics (mainly rifampicin, doxycycline and azithromycin). The visual acuity was noted to be improved in all patients after treatment, but some of them experienced disturbing complications.
Conclusion
CSD may manifest with various ocular pathological findings. Taking into consideration the increasing frequency of infections by B. henselae and B. quintana, clinicians should always incorporate CSD in the differential diagnosis of such presentations of uveitis. Educating vulnerable groups (children, immunosuppressed, etc.) and also general population, the appropriate preventing measures can contribute in limiting the risk of infection.
Similar content being viewed by others
References
Amer R, Tugal-Tutkun I (2017) Ophthalmic manifestations of Bartonella infection. Curr Opin Ophthalmol 28(6):607–612
Jones DB (1996) Cat-scratch disease. In: Pepose JS, Holland GN, Wilhelmus KR (eds) Ocular infection and immunity. Mosby-Year Book, St. Louis, pp 1389–1396
Koehler JE, Glaser CA, Tappero JW (1994) Rochalimaea henselae infection: a new zoonosis with the domestic cat as reservoir. JAMA 16(271):531–535
Chomel BB, Kasten RW, Floyd-Hawkins K, Chi B, Yamamoto K, Roberts-Wilson J, Gurfield AN, Abbott RC, Pedersen NC, Koehler JE (1996) Experimental transmission of Bartonella henselae by the cat flea. J Clin Microbiol 34:1952–1956
Kalogeropoulos C, Koumpoulis I, Mentis A, Pappa C, Zafeiropoulos P, Aspiotis M (2011) Bartonella and intraocular inflammation: a series of cases and review of literature. Clin Ophthalmol (Auckland, NZ) 5:817
Spach DH, Koehler JE (1998) Bartonella-associated infections. Infect Dis Clin North Am 12:137–155
Midani S, Ayoub EM, Anderson B (1996) Cat-scratch disease. Adv Pediatr 43:397–422
Angelakis E, Raoult D (2014) Pathogenicity and treatment of Bartonella infections. Int J Antimicrob Agents 44:16–25
Biancardi AL, Curi ALL (2014) Cat scratch disease. Ocul Immunol Inflamm 22:148–154
Ormerod LD, Dailey JP (1999) Ocular manifestations of cat-scratch disease. Curr Opin Ophthalmol 10:209–216
Saatci AO, Oner FH, Kargi A, Kavukcu S (2002) Unilateral neuroretinitis and peripapillary serous detachment in Cat- scratch disease. Korean J Ophthalmol 16:43–46
Windsor JJ (2001) Cat-scratch disease: epidemiology, aetiology and treatment. Br J Biomed Sci 58:101–110
Jabs DA, Nussenblatt RB, Rosenbaum JT (2005) Standardization of Uveitis Nomenclature (SUN) Working Group. In: Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop, Am J Ophthalmol, vol 140, pp 509–516
Zangwill KM, Hamilton DH, Perkins BA, Regnery RL, Plikaytis BD, Hadler JL, Cartter ML, Wenger JD (1993) Cat-scratch disease in Connecticut: epidemiology, risk factors, and evaluation of a new diagnostic test. N Engl J Med 329:8–13
Dreyer RF, Hopen G, Gass JDM, Smith JL (1984) Leber’s idiopathic stellate neuroretinitis. Arch Ophthalmol 102:1140–1145
Weiss AH, Beck RW (1989) Neuroretinitis in childhood. J Pediatr Ophthalmol Strabismus 26:198–203
Abdelhakim A, Rasool N (2018) Neuroretinitis: a review. Curr Opin Ophthalmol 29(6):514–519
Reed JB, Scales KD, Wong MT, Lattuada CP, Dolan MJ, Schwab IR (1998) Bartonella henselae neuroretinitis in cat scratch disease: diagnosis, management, and sequelae. Ophthalmology 105:459–466
Chi SL, Stinnett S, Eggenberger E, Foroozan R, Golnik K, Lee MS, Bhatti MT (2012) Clinical characteristics in 53 patients with cat scratch optic neuropathy. Ophthalmology 119(1):183–187
Ormerod LD, Skolnick KA, Menosky MM, Pavan PR, Pon DM (1998) Retinal and choroidal manifestations of cat-scratch disease. Ophthalmology 105(6):1024–1031
Solley WA, Martin DF, Newman NJ, King R, Callanan DG, Zacchei T, Wallace RT, Parks DJ, Bridges W, Sternberg P Jr (1999) Cat scratch disease: posterior segment manifestations. Ophthalmology 106(8):1546–1553
Oray M, Önal S, Akbay AK, Tutkun İT (2017) Diverse clinical signs of ocular involvement in cat scratch disease. Turk J Ophthalmol 47(1):9
Eiger-Moscovich M, Amer R, Oray M, Tabbara KF, Tugal-Tutkun I, Kramer M (2016) Retinal artery occlusion due to Bartonella henselae infection: a case series. Acta Ophthalmol 94:e367–e370
Cohen SM, Davis JL, Gass DM (1995) Branch retinal arterial occlusions in multifocal retinitis with optic nerve edema. Arch Ophthalmol 113:1271–1276
Batsos G, Kabanarou SA, Fotiou P, Rouvas A, Xirou T (2013) Retinal arterial occlusive disease in a young patient with cat scratch disease. Case Rep Ophthalmol 4:87–92
Gray A, Michels K, Lauer A, Samples J (2004) Bartonella henselae infection associated with neuroretinitis, central retinal artery and vein occlusion, neovascular glaucoma, and severe vision loss. Am J Ophthalmol 137:187–189
Gray AV, Reed JB, Wendel RT, Morse LS (1999) Bartonella henselae infection associated with peripapillary angioma, branch retinal artery occlusion, and severe vision loss. Am J Ophthalmol 127:223–224
Pinna A, Puglia E, Dore S (2011) Unusual retinal manifestations of cat scratch disease. Int Ophthalmol 31:125–128
Schadlu R, Apte RS (2007) Spontaneous resolution of an inflammation-associated epiretinal membrane with previously documented posterior vitreous detachment. Br J Ophthalmol 91(9):1252–1253. https://doi.org/10.1136/bjo.2006.113597
Andreev AN, Bushuev AV, Svetozarskiy SN (2016) A case of secondary epiretinal membrane spontaneous release. Case Rep Ophthalmol Med 2016:4925763. https://doi.org/10.1155/2016/4925763
Ozgonul C, Besirli CG (2017) Macular hole closure following spontaneous release of vitreomacular traction. BMJ Case Rep. pii: bcr2016218547. https://doi.org/10.1136/bcr-2016-218547
Warren K, Goldstein E, Hung VS, Koehler JE, Richardson W (1998) Use of retinal biopsy to diagnose Bartonella (formerly Rochalimaea) henselae retinitis in an HIV-infected patient. Arch Ophthalmol 116:937–940
Curi AL, Machado D, Heringer G, Campos WR, Lamas C, Rozental T, Gutierres A, Orefice F, Lemos E (2010) Cat-scratch disease: ocular manifestations and visual outcome. Int Ophthalmol 30(5):553–558
Tan CL, Fhun LC, Tai EL et al (2017) Clinical profile and visual outcome of ocular bartonellosis in Malaysia. J Trop Med 2017:7946123
Habot-Wilner Z, Trivizki O, Goldstein M, Kesler A, Shulman S, Horowitz J, Amer R, David R, Ben-Arie-Weintrob Y, Bakshi E et al (2018) Cat-scratch disease: ocular manifestations and treatment outcome. Acta Ophthalmol 96(4):e524–e532
Bergmans AM, Peeters MF, Schellekens JF, Vos MC, Sabbe LJ, Ossewaarde JM, Verbakel H, Hooft HJ, Schouls LM (1997) Pitfalls and fallacies of cat scratch disease serology: evaluation of Bartonella henselae-based indirect fluorescence assay and enzyme-linked immunoassay. J Clin Microbiol 35(8):1931–1937
Vermeulen MJ, Verbakel H, Notermans DW, Reimerink JH, Peeters MF (2010) Evaluation of sensitivity, specificity and cross-reactivity in Bartonella henselae serology. J Med Microbiol 59(Pt 6):743–745
Gulati A, Yalamanchili S, Golnik KC, Lee AG (2012) Cat scratch neuroretinitis: the role of acute and convalescent titers for diagnosis. J Neuroophthalmol 32(3):243–245
Regier Y, O’Rourke F, Kempf VAJ (2016) Bartonella spp.: a chance to establish One Health concepts in veterinary and human medicine. Parasit Vectors 9:261
Acknowledgements
Special thanks to Dr. Aliki Geka (Department of Ophthalmology, Olympion Private Hospital, Patras, Greece), Dr. Dimitrios Kournetas (Laser & Ophthalmos S.A., Thessaloniki, Greece) and Dr. Neoklis Razis (Razis eye clinic, Limassol, Cyprus).
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
Conflict of interest
All authors declare that there is no conflict of interest.
Ethical approval
The research followed the tenets of the Declaration of Helsinki. The Scientific Committee of the University Hospital of Ioannina (Greece) approved the current study on the 6th of November 2018 (Protocol number 1326).
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Kalogeropoulos, D., Asproudis, I., Stefaniotou, M. et al. Bartonella henselae- and quintana-associated uveitis: a case series and approach of a potentially severe disease with a broad spectrum of ocular manifestations. Int Ophthalmol 39, 2505–2515 (2019). https://doi.org/10.1007/s10792-019-01096-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10792-019-01096-7