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Introduction. Cat scratch disease is a common infectious disease caused by intracellular microorganisms Bartonella henselae, which are widespread among wild and domestic animals. The aim of study was to demonstrate a rare clinical case of chorioretinitis against the background of a 10-year-old child’s bartonellosis. Materials and methods. A 10-year-old child received with complaints about a significant decrease of vision and lowering of the upper eyelid of the left eye. The disease began with increase in temperature to 37.5 °C, abdominal pain. Three days later, these ophthalmic complaints appeared. After examining a paediatric ophthalmologist, neurologist and conducting an additional instrumental survey, the patient was hospitalised in an ophthalmological hospital. When acuity of vision of the left eye was 0.02 n/a, the upper eyelid was lowered. On the fundus there was a pronounced extensive edema of the optic nerve disc (OND) with prominance, from OND to the macular zone there was an extensive high retinal swelling. The department conducted a standard clinical examination, blood test for chronic infections, examination of visual evoked potentials and other instrumental examinations. From the first day, local and general antibacterial and anti-inflammatory treatment was carried out. Results and Discussion. Positive dynamics has been observed since the fourth day of treatment, but the visual acuity of the left eye has not improved. On the eighth day, the patient was discharged for subsequent hospitalisation at the Federal State Budgetary Institution NMRC of Eye Diseases named after Helmholtz, in which he was examined for bartonellosis and identified IgG to Bartonella henselae 1:160. Final clinical diagnosed: Left eye neuroretinitis associated with bartonellosis. On the fourteenth day after treatment, the patient was discharged - the left eye was almost calm, visual acuity was 0.06. In this clinical case, a rare manifestation of cat scratches disease is described. Due to the late visit to an ophthalmologist and the late start of medical treatment, it was not possible to fully restore the vision of the left eye. Conclusion. In most cases, it takes a lot of time to make a diagnosis, and specific treatment begins late, in connection with which it is necessary to draw attention to this problem of doctors of different directions. It should also be remembered that any atypical manifestation of the disease serves as a reason to exclude rickettsiosis, including bartonellosis. |
