RESUMO
This case report describes Bartonella henselae neuroretinitis in a 26-year-old woman who presented to the emergency department with unilateral central scotoma and no prodromal symptoms, a unique presentation of this disease. B henselae, a gram-negative bacteria, is the cause of cat scratch disease. Cat scratch disease (CSD) is a self-limiting illness, which typically presents with regional lymphadenopathy, fever, and small skin lesions in associationwith a cat scratch or bite. The mostcommon ocular manifestations of cat scratch disease are Parinaud oculoglandular syndrome and neuroretinitis. All prior reported cases of CSD neuroretinitis presented with prodromal symptoms, not vision loss alone.
Assuntos
Bartonella henselae/isolamento & purificação , Doença da Arranhadura de Gato/diagnóstico , Retinite/microbiologia , Escotoma/microbiologia , Adulto , Doença da Arranhadura de Gato/complicações , Feminino , Humanos , Sintomas Prodrômicos , Retinite/complicações , Retinite/diagnósticoRESUMO
Purpose: To report two cases of syphilitic outer retinopathy that showed diffuse phlebitis on fluorescein angiography (FA).Methods: Retrospective chart review.Results: The two patients had presentation similar to acute zonal occult outer retinopathy (AZOOR), including hyperautofluorescence on fundus autofluorescence and ellipsoid zone disruption on optical coherence tomography. The main difference from AZOOR was the finding of diffuse phlebitis on FA. Both patients recovered well after antibiotic and steroid treatment.Conclusion: FA is especially important for differentiating syphilitic outer retinopathy from AZOOR. Timely diagnosis and treatment with penicillin and cautious use of steroid usually lead to favorable prognosis.
Assuntos
Infecções Oculares Bacterianas/diagnóstico , Flebite/diagnóstico , Veia Retiniana/patologia , Escotoma/diagnóstico , Sífilis/diagnóstico , Síndrome dos Pontos Brancos/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Ceftriaxona/uso terapêutico , Doxiciclina/uso terapêutico , Eletrorretinografia , Infecções Oculares Bacterianas/tratamento farmacológico , Infecções Oculares Bacterianas/microbiologia , Feminino , Angiofluoresceinografia , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Flebite/tratamento farmacológico , Flebite/microbiologia , Prednisolona/uso terapêutico , Estudos Retrospectivos , Escotoma/tratamento farmacológico , Escotoma/microbiologia , Sífilis/tratamento farmacológico , Sífilis/microbiologia , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia , Testes de Campo Visual , Campos Visuais/fisiologia , Síndrome dos Pontos Brancos/tratamento farmacológico , Síndrome dos Pontos Brancos/microbiologiaRESUMO
We review two cases of ocular manifestations of Rickettsia conorii infection in children. A girl who presented unilateral visual loss with focal retinitis and macular oedema and a boy with unilateral central scotoma and bilateral anterior uveitis. Progressive functional and anatomic recovery was observed after oral antibiotics and steroids were initiated.
Assuntos
Febre Botonosa/complicações , Edema Macular/microbiologia , Retinite/microbiologia , Escotoma/microbiologia , Uveíte Anterior/microbiologia , Transtornos da Visão/microbiologia , Febre Botonosa/tratamento farmacológico , Criança , Feminino , Humanos , Edema Macular/tratamento farmacológico , Masculino , Retinite/tratamento farmacológico , Rickettsia conorii , Uveíte Anterior/tratamento farmacológicoRESUMO
A 49-year-old Caucasian woman presented with subacute headache and right eye pain associated with scotoma, blurred vision and photophobia. MRI was suggestive of optic neuritis of the right optic nerve and she was treated with steroids. Due to persistent symptoms, a lumbar puncture was performed and cerebrospinal fluid analysis was positive for venereal disease research laboratory and rapid plasma reagin titres. On further history, she recalled experiencing an illness associated with diffuse rash, likely secondary syphilis, 1-2 months prior. She tested negative for HIV. She was treated with intravenous penicillin for 2 weeks following which she experienced improvement in symptoms.