A child with uveitis as presumed manifestation of cat scratch disease Yoko Sorita 1 , Kohei Ichikawa 1 , Satoko Asaoka 1 , Hiroshi Toshida 1 , Toshikatsu Kaburaki 2 , Toshihiko Ohta 1 1Department of Ophthalmology, Juntendo University Shizuoka Hospital, Shizuoka 2Department of Ophthalmology, The University of Tokyo pp.1327-1333
Published Date 2019/10/15
DOI https://doi.org/10.11477/mf.1410213296
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Abstract Purpose:A 10-year-old girl was referred to us for retinal detachment with choroidal neovascularization in the macular area in the left eye since one month before. She had been treated elsewhere for vernal conjunctivitis since one year before. The left eye had reportedly developed serous retinal detachment 6 months before. It subsided after 2 months of treatment with topical corticosteroid. She had a history of being bitten by a cat.

Findings and Clinical Course:Corrected visual acuity was 1.2 right and 0.4 left. Intraocular pressure was within normal range. Both eyes showed nongranulomatous corneal precipitates, aqueous flare and cells, and anterior synechia of peripheral iris. Both eyes showed swelling optic disc and snowball-like vitreous. The left eye showed serous detachment. Fluorescein angiography showed retinal periphlebitis and hyperfluorescence in the area of fundus exudation. She showed elevated titer of IgG for antibody to Bartonella henselae. These findings led to the diagnosis of uveitis related to cat scratch disease. Treatment with systemic antibiotics and corticosteroid induced improved visual acuity. Bilateral periphlebitis and macular exudation persisted but disappeared after corticosteroid was switched to peroral methotrexate.

Conclusion:Peroral methotrexate was effective for uveitis as presumed manifestation of cat scratch disease in a child.

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