Fever and Vision Loss in an Immunocompetent 20-Year-Old Male
Clinical Infectious Diseases
Clin Infect Dis. 2017 Jan 15;64(2):229
Di Bella S, Rinaldi S , Maurel C, Vattovani O, Luzzati R, Tognetto D
Diagnosis: Bartonella Henselae Neuroretinitis.
Given the history of cat owning and axillary lymphadenopathy,a presumptive diagnosis of Bartonella infection was made. Doxycycline 100 mg and rifampin 300 mg every 12 hours were administered. Immunoglobulin M (IgM) and immunoglobulin G (IgG) for Bartonella henselae were 1:20 and 1:256, respectively, confirming the diagnosis. Systemic steroids were also given since an immune-mediated damage cannot be excluded in the pathogenesis of Bartonella neuroretinitis. During a more accurate interview, the patient recalled repeated scratches by his newly acquired kitten. He experienced prompt defervescence and a progressive improvement of sight with complete recovery after 2-months.