A Case of Neuroretinitis in a Young Male Triggered by Cat Scratch Disease

Abstract

Neuroretinitis is a potentially vision-threatening condition characterised by the swelling of the optic disc, followed by the development of a macular star due to the spread of fluid to the surrounding peripapillary retina. The present case report describes a rare case of unilateral neuroretinitis in a 36-year-old male who presented with an acute, painless decrease in vision in the right eye. The patient exhibited classic signs of neuroretinitis, such as optic disc oedema and a macular star. A systemic work-up ruled out most infectious and inflammatory causes, while serological tests for Cat Scratch Disease (CSD) showed highly reactive results. He was immediately started on appropriate oral antibiotics and steroids for six weeks, after which he experienced significant visual recovery. Managing neuroretinitis involves early investigation, addressing the underlying infection and mitigating the inflammatory response. Challenges include the need for accurate and timely diagnosis, often requiring serological tests and imaging studies. Notably, the present case underscores the importance of considering Bartonella henselae infection in the differential diagnosis of neuroretinitis, particularly in patients with a history of cat exposure. The rarity of such presentations in otherwise healthy young individuals highlights the need for increased awareness and prompt diagnostic evaluation to ensure optimal outcomes and prevent long-term visual impairment.

Keywords

• bartonella henselae
• macular star
• optic disc oedema
• stellate maculopathy
• visual impairment