Título / Title

BARTONELLA HANSELAE RETINITIS PATIENT EVALUATED WITH MULTIMODAL RETINAL EXAMS

Introdução / Purpose

Cat scratch disease is a systemic infectious illness caused by Bartonella hanselae bacteria. The most common ophthalmological Bartonella involvement is Parinaud oculoglandular syndrome, but considering posterior segment findings, the most common are neurorretinitis and subsequent late macular star. Other findings may be present such as retinal or subretinal lesions, intermediate uveitis and angiomatous lesions.

Material e Método / Methods

Our case is about a female patient with retinal findings and serologic confirmation of Bartonella infection, evaluated with multimodal retinal exams. The patient received treatment with doxycycline 100mg twice a day for two weeks.

Resultados / Results

One month after treatment she referred a complete improvement of her visual scotoma symptom. At her retinal fundus examination, it was possible to locate only one of the previous lesions. The swept-source OCT exam also showed a decrease of the lesion size and its intraretinal extension. The microperimetry showed an improvement of the light perception at the affected area.

Discussão e Conclusões / Conclusion

Bartonella hanselae infection, specially retinitis can present variable spectrum of clinical and ophthalmologic finginds. Multimodal retinal exams performed helped to clearly identify lesions characteristics, providing important information that helped us towards the diagnosis and also to evaluate lesions improvement after antibiotic treatment. There was a residual scotoma (without clinical significance) on the region that the lesion with an surrounding halo was still found, despite having reduced with the treatment and clinical evolution, suggesting it might be a characteristic of lesions that can be related with poor prognosis and visual sequela. In this case all the exams showed an improvement of the disease and, to the best of our knowledge, it is the first Bartonella hanselae retinitis report evaluated with multimodal retinal exams, before and after treatment institution, showing objective improvement.

Palavras Chave

retinitis ; bartonella ; multimodal imaging