Kalogeropoulos Dimitrios, Asproudis Ioannis, Stefaniotou Maria, Moschos Marilita M, Mentis Andreas, Malamos Konstantinos, Kalogeropoulos Chris
Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavros Niarchos Avenue, 45110, Ioannina, Greece.
First Department of Ophthalmology, General Hospital of Athens G. Gennimatas, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Int Ophthalmol. 2019 Nov;39(11):2505-2515. doi: 10.1007/s10792-019-01096-7. Epub 2019 Mar 9.
To evaluate the clinical manifestations of intraocular inflammation associated with Bartonella infection and describe the assessment and management of patients with cat-scratch disease (CSD).
This is a retrospective review of the clinical records of patients diagnosed with Bartonella henselae and Bartonella quintana intraocular inflammation from 2011 to 2018 in the Department of Ocular Inflammations and Infections of the University Eye Clinic of Ioannina (Greece). An analysis of the current literature concerning Bartonella-related intraocular infections was also carried out.
This is a retrospective study of 13 patients (7 males and 6 females) with a mean age of 39.2 years that were diagnosed with unilateral intraocular inflammation, except one case with bilateral affection, attributed to Bartonella (either henselae or quintana). Twelve (12) patients (92.3%) had a positive history of traumatic cat contact. The main ocular clinical findings with regard to the type of uveitis included neuroretinitis in 5 eyes (38.5%), vasculitis in 3 eyes (23.1%), iridocyclitis in 2 eyes (15.4%), intermediate uveitis in 2 eyes (15.4%), posterior uveitis in 1 eye (7.7%), panuveitis in 2 eyes (15.4%), retinochoroiditis in 2 eyes (15.4%), vitritis in 1 eye (7.7%), peripheral choroidal granuloma in 1 eye (7.7%). Immunoglobulin (Ig) G was positive in all cases. All patients were treated with antibiotics (mainly rifampicin, doxycycline and azithromycin). The visual acuity was noted to be improved in all patients after treatment, but some of them experienced disturbing complications.
CSD may manifest with various ocular pathological findings. Taking into consideration the increasing frequency of infections by B. henselae and B. quintana, clinicians should always incorporate CSD in the differential diagnosis of such presentations of uveitis. Educating vulnerable groups (children, immunosuppressed, etc.) and also general population, the appropriate preventing measures can contribute in limiting the risk of infection.
评估与巴尔通体感染相关的眼内炎症的临床表现，并描述猫抓病（CSD）患者的评估与管理。
这是一项对2011年至2018年在希腊约阿尼纳大学眼科诊所眼内炎症与感染科被诊断为亨氏巴尔通体和五日热巴尔通体所致眼内炎症患者的临床记录进行的回顾性研究。同时还对有关巴尔通体相关眼内感染的当前文献进行了分析。
这是一项对13例患者（7例男性和6例女性）的回顾性研究，平均年龄为39.2岁，除1例双侧受累外，均被诊断为单侧眼内炎症，病因是巴尔通体（亨氏或五日热）。12例（92.3%）患者有与猫创伤接触史。关于葡萄膜炎类型的主要眼部临床发现包括5只眼（38.5%）为视神经视网膜炎、3只眼（23.1%）为血管炎、2只眼（15.4%）为虹膜睫状体炎、2只眼（15.4%）为中间葡萄膜炎、1只眼（7.7%）为后葡萄膜炎、2只眼（15.4%）为全葡萄膜炎、2只眼（15.4%）为视网膜脉络膜炎、1只眼（7.7%）为玻璃体炎、1只眼（7.7%）为周边脉络膜肉芽肿。所有病例免疫球蛋白（Ig）G均为阳性。所有患者均接受了抗生素治疗（主要是利福平、多西环素和阿奇霉素）。治疗后所有患者的视力均有改善，但其中一些患者出现了令人困扰的并发症。
CSD可能表现为各种眼部病理表现。考虑到亨氏巴尔通体和五日热巴尔通体感染频率的增加，临床医生在对此类葡萄膜炎表现进行鉴别诊断时应始终将CSD纳入考虑。对弱势群体（儿童、免疫抑制者等）以及普通人群进行教育，采取适当的预防措施有助于降低感染风险。
