A study has found the mainstream news media. It is about cat scratch fever (disease) causing partial blindness in a Texas man, aged 47. It is published online in the American Journal of Case Reports. The study is called “Bartonella Neuroretinitis: There Is More to Cat Scratch Disease Than Meets the Eye”. The conclusion to the study is that it is important to diagnose Bartonella neuroretinitis EARLY in order to prevent vision loss and shorten recovery time.
RELATED: Cat Scratch Fever
The study report describes a 47-year-old man who presented with nonspecific symptoms of headache, fevers, and visual changes. The patient had recently adopted a cat and was subsequently diagnosed with Bartonella neuroretinitis, which is a form of Cat Scratch Disease (CSD) that presents with ocular symptoms such as central scotoma, rather than the typical lymphadenopathy of CSD.
An interesting part of the story is that he said that his cat scratched him frequently. Without being critical, any cat caregiver should not allow their cat to scratch them frequent and if they do it is down to poor cat caretaking obviously. To a certain extent, this man is the author of his own demise as they say.
The patient was diagnosed with grade 3 optic disc edema with small disc hemorrhages bilaterally without lymphadenopathy, and Bartonella henselae serologies returned positive for the disease. The patient was treated with doxycycline and rifampin, which are the current standard of treatment for 4 to 6 weeks. Doxycycline is an antibiotic and rifampin is an in a class of medications called anti-mycobacterials. It kills the bacteria that causes the infection.
Also, the consensus is that these drugs can be supplemented with corticosteroids to aid in the treatment.
At the follow-up outpatient ophthalmology visit, the patient had symptomatically improved vision, with dilated fundus examination (DFE) supporting reduced optic disc edema in the right eye.
“DFE is a diagnostic procedure that employs the use of pupil dilating eye drops to dilate or enlarge your pupil. It allows the optometrist to obtain a better view of the fundus of you eye and to look for signs of eye disease such as diabetes, retinal detachment, and other retinal issues.” – swisscoat.eu.
As mentioned, the case report highlights the importance of early recognition and treatment of Bartonella neuroretinitis to prevent vision loss and shorten recovery time. The supplementation of corticosteroids with these antibiotics is also indicated in the growing body of literature.
The vision in his left eye had shrunk to 20/100 which means that we need to be within 20 feet of an object to see it as if it was a hundred foot away. The partial loss of vision was apparently sudden.
Apparently, cat scratch fever infects about 12,000 Americans annually. It is believed that the infection reaches the optic nerve via the bloodstream. It causes the optic nerve to become inflamed which is a barrier to signals being sent from the retina to the brain.
The bacteria delivered the human with cat scratch fever, Bartonella henselae, is the leading cause of infectious neuroretinitis.
The disease causes vision loss in 1-2% of cases. It is, therefore, very rare but significant. It is also significant that it can be cured straightforwardly with antibiotics and the other drug, rifampin.
Other symptoms to the one specified include fevers, headaches, nausea. The Texas man concerned thought he had Covid-19 until Bartonella neuroretinitis was diagnosed at the ER department of a hospital.
Postscript: this is an afterthought and it’s common sense but there is no need for a sensible cat caregiver to be scratched. They can be avoided. It’s a question of reading your cat and understanding cat behaviour to be able to judge when a scratch mine arrived. And if a cat is scratching their caregiver, it is because of something that the caregiver is doing such as waving their hand around in front of the cat’s face. Or, it might be petting them to aggressively or with too much passion. Cats transfer this into play fighting. It’s a question about understanding domestic cats.
In 9/10 cases, a cat scratch is nothing to worry about. It simply goes away but sometimes they can cause real problems because a bacterial infection takes hold, of the type described above, or by a different species of bacteria. You don’t want this to happen and if it does you have to take antibiotics promptly.
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