Choroidal granulomas due to Bartonella henselae infection: A case series

Eur J Ophthalmol. 2022 Nov;32(6):3498-3502. doi: 10.1177/11206721221091376. Epub 2022 Apr 21.

Abstract

Purpose: To report a case series of 3 patients with choroidal granulomas due to Bartonella henselae infection in order to raise awareness about this etiology in the differential diagnosis of choroidal granulomas.

Methods, patients: A retrospective case series of patients with choroidal granulomas due to Bartonella henselae infection who consulted between 2018 and 2020. Data were collected from the medical records (demographics, visual acuity (VA), laboratory tests, treatment, imaging).

Results: Patients were a 48-year old man, a 14-year old girl and a 31-year old man. They all had a choroidal granuloma seen on optical coherence tomography (OCT) and angiography. The laboratory work-up revealed a positive serology for Bartonella henselae in all patients.

Conclusion: On multimodal imaging choroidal granulomas in B Henselae appeared as single or multiple, uni or bilateral round yellowish lesions. Fluorescein and indocyanine green angiography of the granuloma showed respectively a late staining and a hypofluorescence. On EDI-OCT choroidal granuloma appeared as a round hyporeflective lesion in the choroid with a retinal elevation. The exclusion of other diagnosis, the natural course and the serology must lead the ophthalmologist to evoke the diagnosis.

Keywords: Bartonella henselae; cat scratch disease; choroidal granuloma.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Cat-Scratch Disease* / complications
  • Cat-Scratch Disease* / diagnosis
  • Cat-Scratch Disease* / pathology
  • Choroid / pathology
  • Female
  • Fluorescein Angiography
  • Fluoresceins
  • Granuloma / diagnosis
  • Granuloma / etiology
  • Granuloma / pathology
  • Humans
  • Indocyanine Green
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tomography, Optical Coherence / methods

Substances

  • Fluoresceins
  • Indocyanine Green