Severe occlusive vasculitis as a complication of cat scratch disease.

BACKGROUND

The purpose of this communication is to report a severe occlusive vasculitis as a complication of cat scratch.

HISTORY AND SIGNS: A 34-year-old Hispanic woman presented with a sudden visual loss of the right eye associated with shivers, high fever and arthritis which developed 2 months after a cat's bite. Fundus examination showed papillitis and a palor of the paramacular zone of the retina. Fluorescein angiography revealed multiple arterial and venous vasculitic occlusions.

THERAPY AND OUTCOME: Auto-immune disease and endocarditis were ruled out by an extensive medical work-up. The diagnosis of Bartonella henselae was confirmed by a positive serology. A systemic antibiotherapy with azithromycin, doxycyclin, rifampicin and steroid therapy resulted in a good clinical response, including a rapid visual recovery with a visual acuity of 20/20 and no relapse of the disease at 6 months follow-up.

CONCLUSIONS

Ocular complications associated with cat scratch disease may include vasculitis with both arterial and venous occlusions causing severe visual loss.