Bartonellosis causing bilateral Leber neuroretinitis: a case report

PURPOSE. Bartonella henselae is the causal agent of cat scratch disease and one variation in its presentation is Leber neuroretinitis. The unilateral presence of exudation as a macular star and papilledema represent its most common presentation. METHODS. Observational case report. A 7-year-old girl presented a sudden decrease of visual acuity and bilateral macular exudation (macular star) as well as choroiditis. RESULTS. A complete recovery of visual acuity was seen after a 6-week follow-up. Erythromycin plus deflazacort treatment was given. CONCLUSIONS. The present case represents an unusual variety of cat scratch disease. This represents a challenge in the differential diagnosis of diseases such as Lyme disease and tuberculosis among others. (Eur J Ophthalmol 2009; 19: 307-9)