Not cat-scratch disease: Bartonella henselae neuroretinitis associated with non-feline pet mammals

• Main Authors: Jorge Orellana-Rios, Juan I. Verdaguer-Diaz, Gabriela Opazo, Belinda C.S. Leong, Claudio Zett, R. Theodore Smith, K. Bailey Freund
• Format: Article
• Language: English
• Published: Elsevier 2020-01-01
• Series: IDCases
• Subjects: Cat-scratch disease; Neuroretinitis; Bartonella henselae; Retinitis; Ferret; Guinea pig
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214250920302869

To describe the ocurrence of Bartonella-associated neuroretinitis secondary to non-feline pet exposure, we retrospectively reviewed medical records and imaging from patients with a clinical and serologic diagnosis of Bartonella henselae (BH). Retinal imaging included color fundus photography, optical coherence tomography (OCT) and fluorescein angiography (FA). Four eyes of two patients with cat-scratch disease were included in this study, with a mean age of 35 years. The mean follow-up was 13 months, after presentation of infectious neuroretinitis. Both patients suffered from bilateral neuroretinitis after direct contact with family pets (ferret and guinea pig). All patients were treated with a long-term systemic antimicrobial therapy. Visual acuity in all improved to 20/30 or better at six months. In conclusion, humans may develop cat-scratch disease when they are exposed to Bartonella henselae (BH) in the saliva of infected cats or BH-containing flea feces reaching the systemic circulation through scratches or mucous membranes. As the cat flea (Ctenocephalides felis) may reside on non-feline mammals, Bartonella-associated neuroretinitis may result from contact with other furred family pets.