Cat-Scratch uveitis examined
By Linda on Dec 30, 2010 in Infections
Excerpt:
PURPOSE:: To report a case of a cat-scratch uveitis caused by Bartonella
henselae, which was confirmed by histology, serology, and polymerase chain
reaction (PCR) methodology.
METHODS:: An iris nodule was biopsied from a 4-year-old child who was
scratched by a kitten on the side of his face and developed redness of the
eye associated with cervical lymphadenopathy. Sections of the iridectomy
specimen were stained with hematoxylin-eosin, periodic acid-Schiff, and
Warthin-Starry technique for histopathologic evaluation.
Additionally, serologic tests and molecular diagnosis using B.
henselae-specific PCR were performed.
RESULTS:: Histopathologically, sections of the iridectomy specimen showed a
zonal granulomatous inflammation with a central iris necrotic abscess
surrounded by a mantle of epithelioid histiocytes and more peripherally by
lymphocytes and plasma cells. The Warthin-Starry stain disclosed scattered
short bacilli within the necrotic abscess morphologically compatible with B.
henselae. Report of serologic tests for B. henselae disclosed a negative
immunoglobulin G antibody (negative: less than 12) and a positive
immunoglobulin M antibody of 18 (positive: greater than 15). Other serologic
studies including Toxocara, histoplasmin, blastomycin, coccidioidin,
aspergillin, and Chlamydia were all negative. PCR was positive for B.
henselae DNA.
CONCLUSIONS:: Our case
showed a unilateral chronic granulomatous iritis with the histopathologic
features compatible with CSD caused by B. henselae bacillus as demonstrated
in the iris biopsy and confirmed by serology and PCR technique. This case is
an example of a relatively rare uveal manifestation of CSD.
