# Cat-Scratch Disease Presenting as Isolated Neuroretinitis (Bartonella henselae): A Case Report

## TL;DR

A teenager with no typical symptoms of cat-scratch disease was diagnosed with isolated eye inflammation caused by Bartonella henselae, highlighting the need to consider this infection in unusual eye cases.

## Contribution

This case report presents an unusual presentation of cat-scratch disease as isolated neuroretinitis without systemic symptoms.

## Key findings

- An 18-year-old female presented with neuroretinitis and no constitutional symptoms of cat-scratch disease.
- Diagnosis was confirmed through cat exposure history and positive Bartonella henselae serology.
- Treatment with antibiotics and steroids led to significant visual improvement.

## Abstract

Cat-scratch disease (CSD), a rare infectious disorder typically presenting with systemic manifestations such as fever and lymphadenopathy, uncommonly involves ocular structures, with neuroretinitis being one of its more frequent ocular manifestations. We report an unusual case of CSD presenting as isolated neuroretinitis in the absence of constitutional symptoms. The patient is an 18-year-old female who presented with decreased vision in her left eye and the appearance of shadows. She reported no systemic symptoms such as fever or swollen lymph nodes. Fundus examination revealed optic disc edema, retinal edema in the posterior pole, and macular star exudates. Diagnosis was confirmed by a history of cat exposure and positive serology for Bartonella henselae antibodies. Treatment with oral doxycycline, combined with azithromycin and low-dose glucocorticoids, resulted in significant visual improvement. This case highlights that CSD should be considered in cases of unexplained neuroretinitis, and a careful history regarding cat contact is essential to avoid misdiagnosis.