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December 1997

Inflammatory Mass of the Optic Nerve Head Associated With Systemic Bartonella henselae Infection

Author Affiliations

San Francisco, Calif
St Louis, Mo

Arch Ophthalmol. 1997;115(12):1596-1597. doi:10.1001/archopht.1997.01100160766021

Cat-scratch disease is caused by Bartonella henselae, a pleomorphic gram-negative rod formerly referred to as Rochalimaea henselae. Common ocular sequelae include Parinaud oculoglandular syndrome and neuroretinitis.1 Acute multifocal retinitis with or without optic nerve edema may also occur,2 occasionally causing a branch retinal artery occlusion3 or serous detachment of the neurosensory retina.4 We describe the use of a recently developed indirect fluorescent antibody test5 to document systemic B henselae infection in 2 patients with an unusual inflammatory mass of the optic nerve head after a flulike illness and exposure to cats.

Report of Cases. 

Case 1.  A 7-year-old girl was seen with profound loss of vision in her left eye 2 months after an acute febrile illness. Her medical history was notable for multiple recent cat scratches. Best-corrected visual acuity was 20/20 OD and no light perception OS. An afferent pupillary defect was present in