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Abstract: Relato de caso de doença da arranhadura do gato (DAG), em um paciente lactente, com história epidemiológica negativa, descrevendo o. Request PDF on ResearchGate | On Jan 1, , Mauricio Magalhaes Costa and others published Doença de arranhadura do gato simulando carcinoma oculto. (conjuntivite com adenite satélite pré-auricular) causada por Bartonella henselae, o agente etiológico da Doença da Arranhadura do Gato.

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Optic neuropathy secondary to cat scratch disease: Optic neuropathy due to cat scratch disease is a relatively infrequent occurrence associated with macular star formation and is characterized by sudden painless loss of vision mostly unilateral.

Bartonella henselae is well recognized as the etiologic agent in cat scratch disease. Ocular bartonelosis is usually self-limited with complete or near-complete recovery of vision in otherwise healthy patients. A case of a boy with neuroretinitis caused by B.

Relatamos o caso de um adolescente com neuroretinite causada por Arranhasura.

Familial occurrence of zoonotic sporotrichosis

Optic neuropathy refers to a clinical disorder characterized by sudden-to-chronic loss of vision in one or both eyes due to optic nerve dysfunction that might be idiopathic, ischemic, primary demyelinating, infectious, or inflammatory in etiology 1. Neuroretinitis is a form of optic neuropathy, characterized by acute painless visual loss in association with optic disc swelling and macular stellated exsudate.

It is tipically unilateral and has an excellent prognosis regardless of treatment. Optic neuropathy due cat scratch disease is a relatively infrequent occurrence caused by Bartonella henselae. Other infectious causes include syphilis, Lyme disease, viruses and diffuse unilateral subacute neuroretinitis.

Cat scratch disease has been reported in the literature for more coenca half a century as a syndrome of regional lymphadenopathy and fever.

However, it has been only a quarter of a century since Bartonella henselae was identified as the etiologic agent.

Doença por arranhadura do gato

They are small, fastidious, intracellular Gram-negative bacilli that are aerobic and oxidase-negative 2. Cats are the major reservoir for B. The cat flea is responsible for the major mode of transmission between cats. Once transmitted to humans, following the scratch or bite of a kitten or adult cat, B. The response to infection depends on the immune status of the infected host.


The typical cat scratch disease is characterized by lymphadenopathy with fever, benign and self-limited, with no other signs or symptoms 3. Other manifestations are less common hepato-esplenomegaly, granulomatous hepatitis, osteomyelitis, encephalitis, glomerulonephritis, endocardites, and pneumonia. The most common ocular manifestations is the Parinaud syndrome that consist of fever, regional lymphadenopathy, and follicular conjuntivitis, followed by the neuroretinitis 2. We describe a case of ocular bartonellosis in one adolescent, with unilateral sudden painless vision loss and neuroretinitis.

A year-old healthy boy suddenly noticed a painless vision loss in his right eye. He denied pain on eye movements and had no systemic or neurological complaints. The swinging flashlight test showed a prominent right relative afferent pupillary defect. The fundoscopy in the left eye was unremarkable but in the right eye revealed a diffusely swollen, hyperemic optic disc, serous detachment extending from the disc to the macula, and macular exudates in a stellate pattern Figure 1 OD.

The patient referred scratches on the left arm by a kitten two weeks before his eyesight was affected. Dyschromatopsia was seen in right eye. Chest x-ray, complete blood count with differential was normal.

Erythrocyte sedimentation rate was 4 mm. Tuberculin skin test was 6 mm.

Serologic tests to toxoplasmosis, cytomegalovirosis and HIV 1 and 2 were negative. Cerebrospinal fluid studies revealed normal cell count, normal chemistries, and absent oligoclonal bands. Magnetic resonance images of the head and orbits were normal. The patient started a 3-week course of oral mg Doxycycline once daily. Bartonella henselae IgG was positive at a titer of 1: The prominent right relative afferent pupillary defect persisted.

The optic disc swelling was markedly reduced and the macula stellate exsudates remained.

The pupillary response was normal. The optic disc swelling diminished and the macular stellate remained in the temporal side. Optic neuropathy can be due to various causes that show significant doecna in clinical presentation and clinical examination 1. The Optic Neuritis Treatment Trial has shown that intravenous administration of high-dose steroids decreases the risk of progression of optic neuropathy to multiple sclerosis within 2 years of follow-up 5.

The diagnosis of the underlying cause of optic neuropathy should be established as soon as possible. The diagnosis of B. The most common posterior segment ocular complication of B.


Doença por arranhadura do gato – Wikipédia, a enciclopédia livre

Neuroretinitis is characterized by acute visual loss due to optic nerve edema associated with macular exudates in a starlike pattern. The macular star formation may not develop until 1 to 2 weeks after the initial presentation 6. The exact prevalence of neuroretinitis by B. On MRI, the optic-globe nerve junction is highly specific for B. The macular exudates take months to resolve, and even after resolution, patients may experience abnormal color vision and evoked potentials, subnormal contrast sensitivity, residual disc pallor, afferent pupillary defects, retinal pigment changes, and mildly decreased visual acuity 2,8.

There are reports of ocular Bartonella disease with optic disc edema and retinal detachment without the classic macular stellate exudative 9.

Other posterior segment presentations of B. Whether immunocompetent individuals ddoenca ocular cat scratch disease need treatment is debatable since the natural progression is for complete recovery within a few months. However, systemic antibiotics do seem to shorten the disease duration and speed visual recovery.

Alternatives to azythromycin include rifampicin, ciprofloxaxin, gentamicin, and trimethoprim-sulfamethoxazole, in order of increased effectiveness 2.

Although the prognosis is on the whole good there may be residual loss of visual acuity, disc pallor, afferent pupillary defects and retinal pigmentary changes. Early signs that help to distinguish B. Beyond cat scratch disease: Bartonella henselae infection associated with neuroretinitis, gxto retinal artery and vein occlusion, neovascular glaucoma, and severe vision loss.

Arch Soc Esp Oftalmol. Macular star in neuroretinitis. Pattern areanhadura evoked potentials in eyes with disc swelling due cat scratch disease-associated neuroretinitis. Optic disk edema associated with peripapillary serous retina detachment: Macular hole in cat scratch disease.

Downca henselae neuroretinitis in cat scracht disease. Diagnosis, management, and sequelae. All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Services on Demand Journal. Rua Casa do Ator, – cj. How to cite this article.