A patient presented with subacute painless decreased vision in the left eye. On examination, she had evidence of stellate macular exudates in the left eye, as well as optic disc edema in the right eye. Imaging including fluorescein angiography and OCT of the macula and retinal nerve fiber layer were performed during initial visit, demonstrating leakage at the optic nerve in the right eye, and intraretinal exudates in the left eye. MRI studies of the brain and orbits were performed which were normal. The patient recently obtained a kitten and did endorse recent cat bite. Empiric treatment with antibiotics or steroids was deferred at initial visit. Laboratory workup including inflammatory and infectious causes was positive for Bartonella henselae infection. At most recent follow up, the patient’s clinical examination had demonstrated significantly improved visual acuity, decreased optic disc edema, and stability of macular exudates. She was recommended to start course of tetracycline for eradication of Bartonella infection. This case demonstrates clinical signs and symptoms of infectious neuroretinitis due to Bartonella, and close follow-up demonstrating both clinical and symptomatic improvement.
Presentation Date: 11/17/2022
Issue Date: 12/23/2022