Ocular Bartonellosis - sight-threatening manifestations of tick-borne disease

*Summary*
Bartonella infections continue to be a burden worldwide and 
epidemiologic features may guide preventive measures in high-risk 
regions and populations. An increased awareness of diverse posterior 
segment manifestations will lead to an early diagnosis of ocular 
bartonellosis. Laboratory diagnostic methods continue to evolve and may 
be applied to the investigation of ocular fluids for a definitive 
diagnosis of ocular bartonellosis. Well designed clinical trials are 
required to establish the optimum treatment of especially 
sight-threatening manifestations.

https://doi.org/10.1097/ICU.0000000000000419

Abstract

*Purpose of review*
The eye is commonly affected in disseminated cat scratch disease (CSD) 
caused by Bartonella species. This article reviews recently published 
data on epidemiology of CSD, clinical features of ocular involvement, 
diagnosis and treatment.

*Recent findings*
The annual incidence of CSD has been estimated as 4.7 per 100 000 in the 
United States. It occurs predominantly in the southern states, with a 
peak in January, and disproportionately affects children. Retinal 
infiltrates, neuroretinitis and branch retinal artery occlusions have 
been reported as common manifestations of ocular bartonellosis in recent 
series. The use of different antigens for serodiagnosis and new 
real-time PCR assays for molecular diagnosis have been described. 
Despite lack of a standard treatment, good visual outcomes were 
generally reported in patients with ocular bartonellosis.