Neuroretinitis in a case of cat scratch disease

Purpose: To report optic neuroretinitis in a case of cat scratch disease. Case: A 40-year-old woman presented with impaired vision in her left eye since 10 days before. She had had fever and headache since one month before. She had been receiving treatment for diabetes and systemic hypertension. Findings and Clinical Course: Corrected visual acuity was 1.2 right and 0.05 left. The left eye showed hyperemia and swelling of optic disc. Optical coherence tomography showed serous retinal detachment in the central fundus area in the left eye. Fluorescein angiography showed dye leakage in the disc in both eyes. Further inquiry showed that she was living with several cats at home. Her systemic blood was positive for antibody to Bartonellae henselae, leading to the diagnosis of neuroretinitis as manifestation of cat scratch disease. She was treated by subtenon injection of triamcinolone and peroral azithromycin, followed by cure of disc swelling and retinal detachment. She showed visual acuity of 1.0 in either eye 6 months later. Conclusion: This case illustrates that detailed history taking may give a clue to the diagnosis of cat scratch disease.