Bartonella henselae- and quintana-associated uveitis: a case series and approach of a potentially severe disease with a broad spectrum of ocular manifestations.

Authors:
Dimitrios Kalogeropoulos
Dimitrios Kalogeropoulos
School of Health Sciences
Tulsa | United States
Ioannis Asproudis
Ioannis Asproudis
University Hospital of Ioannina
Greece
Maria Stefaniotou
Maria Stefaniotou
University of Ioannina
Greece
Marilita M Moschos
Marilita M Moschos
University of Athens
Greece
Andreas Mentis
Andreas Mentis
Hellenic Pasteur Institute
Greece
Konstantinos Malamos
Konstantinos Malamos
School of Health Sciences
Chris Kalogeropoulos
Chris Kalogeropoulos
Medical School
Greece

Int Ophthalmol 2019 Mar 9. Epub 2019 Mar 9.

Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavros Niarchos Avenue, 45110, Ioannina, Greece.

Purpose: To evaluate the clinical manifestations of intraocular inflammation associated with Bartonella infection and describe the assessment and management of patients with cat-scratch disease (CSD).

Methods: This is a retrospective review of the clinical records of patients diagnosed with Bartonella henselae and Bartonella quintana intraocular inflammation from 2011 to 2018 in the Department of Ocular Inflammations and Infections of the University Eye Clinic of Ioannina (Greece). An analysis of the current literature concerning Bartonella-related intraocular infections was also carried out.

Results: This is a retrospective study of 13 patients (7 males and 6 females) with a mean age of 39.2 years that were diagnosed with unilateral intraocular inflammation, except one case with bilateral affection, attributed to Bartonella (either henselae or quintana). Twelve (12) patients (92.3%) had a positive history of traumatic cat contact. The main ocular clinical findings with regard to the type of uveitis included neuroretinitis in 5 eyes (38.5%), vasculitis in 3 eyes (23.1%), iridocyclitis in 2 eyes (15.4%), intermediate uveitis in 2 eyes (15.4%), posterior uveitis in 1 eye (7.7%), panuveitis in 2 eyes (15.4%), retinochoroiditis in 2 eyes (15.4%), vitritis in 1 eye (7.7%), peripheral choroidal granuloma in 1 eye (7.7%). Immunoglobulin (Ig) G was positive in all cases. All patients were treated with antibiotics (mainly rifampicin, doxycycline and azithromycin). The visual acuity was noted to be improved in all patients after treatment, but some of them experienced disturbing complications.

Conclusion: CSD may manifest with various ocular pathological findings. Taking into consideration the increasing frequency of infections by B. henselae and B. quintana, clinicians should always incorporate CSD in the differential diagnosis of such presentations of uveitis. Educating vulnerable groups (children, immunosuppressed, etc.) and also general population, the appropriate preventing measures can contribute in limiting the risk of infection.

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Source
http://link.springer.com/10.1007/s10792-019-01096-7
Publisher Site
http://dx.doi.org/10.1007/s10792-019-01096-7DOI Listing

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March 2019
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