Optic Neuritis and Vertebral Osteomyelitis: An Uncommon Presentation of Cat-Scratch Disease.
| Autor: | Carujo A; Infectious Diseases Department, Santo António University Hospital, Porto, PRT., Santos Silva A; Infectious Diseases Department, Santo António University Hospital, Porto, PRT.; Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, PRT., Videira Santos F; Infectious Diseases Department, Santo António University Hospital, Porto, PRT., Furtado MJ; Ophthalmology Department, Santo António University Hospital, Porto, PRT.; Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, PRT., Vasconcelos AL; Infectious Diseases Department, Santo António University Hospital, Porto, PRT.; Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, PRT. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2024 Jan 15; Vol. 16 (1), pp. e52284. Date of Electronic Publication: 2024 Jan 15 (Print Publication: 2024). |
| DOI: | 10.7759/cureus.52284 |
| Abstrakt: | In cat-scratch disease (CSD), hematogenous spread may result in atypical presentations. Ocular manifestations develop in a minority of patients, with treatment being important in reducing long-term visual sequelae. Bone infection is rare. We present the case of a 52-year-old woman, with close contact with cats, reporting acute unilateral blurred vision and presenting papilledema, optic disc pallor, and peripapillary hemorrhage. Etiologic study of optic neuritis revealed an elevated positive Bartonella IgG; hence, treatment for CSD with doxycycline plus rifampin and corticosteroids was started. Concomitant lumbar pain of increasing intensity warranted magnetic resonance imaging, which revealed L3-L4 vertebral osteomyelitis with spondylodiscitis. Given the temporal link with CSD diagnosis and the significant clinical improvement since its treatment was started, an etiologic link was presumed and antibiotics were prolonged. This case stands out for the presence of distinct atypical CSD manifestations in the same patient. Further studies are needed to determine the optimal treatment for rare manifestations, particularly bone infection. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Carujo et al.) |
| Databáze: | MEDLINE |
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