Neuroretinitis and chorioretinitis in a cat-scratched young boy: a case report

TL;DR

A 10-year-old boy developed vision loss and eye inflammation after being scratched by a cat, leading to a diagnosis of neuroretinitis and chorioretinitis.

Contribution

This case report highlights the progression from optic neuritis to chorioretinitis in a pediatric patient with cat scratch disease.

Findings

The patient initially presented with symptoms consistent with optic neuritis.

Subsequent chorioretinal foci led to a revised diagnosis and treatment plan.

Cat scratch disease was identified as the underlying cause of the ocular inflammation.

Abstract

Neuroretinitis is an inflammatory type of optic nerve damage evidenced by the appearance of papillary edema. It also involves inflammation of the retinal layers, as evidenced by the thickening of these layers and the presence of intra- and subretinal fluid. Chorioretinitis is a condition in which inflammation of the posterior component of the uvea, the choroid, leads to further damage to the retina, causing it to become inflamed.

The most common causes of neuroretinitis and chorioretinitis in the pediatric population are represented by infectious etiologies. Most cases of neuroretinitis in children are caused by cat scratch disease, which is typically attributed to the bacterium Borrelia burgdorferi.

We present the case of a 10-year-old child who presented to our service complaining of a sudden decrease in vision and the appearance of a central scotoma two days before he was referred to our service. Our first diagnosis was of optic neuritis, based on the presence of objective papillary edema on fundus examination. Subsequently, the appearance of chorioretinal foci completely changed the diagnosis and treatment in this case.

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