PURPOSE: To review recent advances in the basic and clinical biology of Bartonella-related eye disease.
METHOD: A review of the pertinent medical literature was performed.
RESULTS: A number of novel Bartonella species have been identified over the past decade. Of these, Bartonella henselae, the etiologic agent in cat scratch disease, is most often associated with ocular complications, which may include Parinaud oculoglandular syndrome, neuroretinitis, and focal retinochoroiditis. Although cat and flea exposure appear to be the main risk factors for contracting cat scratch disease, the diagnosis of ocular bartonellosis relies primarily on the recognition of suggestive clinical signs in conjunction with positive serologic testing. B. henselae–associated ocular complications are usually self-limited but may be treated with doxycycline or erythromycin, with or without rifampin, when the infections are severe or sight-threatening.
CONCLUSIONS: B. henselae infection is common and should be considered in patients with Parinaud oculoglandular syndrome, neuroretinitis, or focal retinochoroiditis, particularly when there is a history of cat or flea exposure.
aThe Francis I. Proctor Foundation, Department of Ophthalmology, University of California, San Francisco, Medical Center, San Francisco, California, USA
bThe Division of Infectious Diseases, The Department of Medicine, University of California, San Francisco, Medical Center, San Francisco, California, USA
Correspondence to Emmett T. Cunningham, Jr., MD, PhD, MPH, The Pearl & Samuel J. Kimura Ocular Immunology Laboratory, The Francis I. Proctor Foundation, University of California, San Francisco, Medical Center, San Francisco, California 94143-0944; fax: (415) 476-0527
☆ Dr Cunningham was supported in part by a Career Development Award from Research to Prevent Blindness, Inc, New York, New York. Dr Koehler received support from the California University–wide AIDS Research Program and NIH R01 AI43703, Bethesda, Maryland.
ABSTRACT