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Conservative management of documented neuroretinitis in cat scratch disease associated with Bartonella henselae infection.
Rosen, B S; Barry, C J; Nicoll, A M; Constable, I J.
Afiliación
  • Rosen BS; Centre for Ophthalmology and Visual Science, Lions Eye Institute, Nedlands, Western Australia, Australia. bradrosen@hotmail.com
Aust N Z J Ophthalmol ; 27(2): 153-6, 1999 Apr.
Article en En | MEDLINE | ID: mdl-10379716
BACKGROUND: Bartonella henselae has been identified as the causative agent of the neuroretinitis associated with cat scratch disease (CSD). Immunofluorescent antibody tests with good sensitivity and specificity are available to aid in diagnosis. Despite diagnostic advances, optimal management remains controversial. We present a case of documented B. henselae macular neuroretinitis managed without antibiotics and discuss antibiotic use in this condition. METHODS: We examined a young woman with macular neuroretinitis and established a diagnosis of CSD. Management consisted of a review of the literature, followed by educating her about the condition and close observation. We documented the course of her disease. RESULTS: We diagnosed neuroretinitis associated with B. henselae infection based on immunofluorescent antibody titres and clinical presentation. Our patient's neuroretinitis resolved promptly without antibiotic therapy. CONCLUSIONS: Macular neuroretinitis in CSD can be satisfactorily diagnosed with the use of fluorescent antibodies in the appropriate clinical setting. Optimal treatment for the disease has not been established and observation combined with patient education remains an appropriate option. The self-limited nature of the disease implies that treatment studies not using controls must be interpreted with great caution. Adverse drug reactions and other iatrogenic complications can be reduced by limiting antibiotic use in settings where a meaningful treatment benefit has not been established.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Retinitis / Enfermedad por Rasguño de Gato / Neuritis Óptica / Bartonella henselae Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Animals / Female / Humans Idioma: En Revista: Aust N Z J Ophthalmol Asunto de la revista: OFTALMOLOGIA Año: 1999 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Australia
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Retinitis / Enfermedad por Rasguño de Gato / Neuritis Óptica / Bartonella henselae Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Animals / Female / Humans Idioma: En Revista: Aust N Z J Ophthalmol Asunto de la revista: OFTALMOLOGIA Año: 1999 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Australia