A Rare Case of Pediatric Bartonella Neuroretinitis

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Authors

• Katie McCarthy, Michigan State University College of Human Medicine Medical Student
• Gabby Young, Michigan State University College of Human Medicine Medical Student
• Stephen Gunnink, Corewell Health West

Description

Bartonella henselae is an aerobic Gram-negative bacterium that typically resides asymptomatically in the saliva of its hosts, domestic cats. It can be transferred directly to humans through scratches or bites or indirectly via infected fleas or ticks. It causes a self-limited infection called cat scratch disease and is the most common cause of neuroretinitis1. However, Bartonella neuroretinitis often goes undetected in children and adolescents and can progress to permanent vision loss without prompt treatment2. It remains a very rare, but treatable, cause of acute vision loss especially in children and adolescents and is therefore worthy of further study to reduce severe complications and improve recovery time for patients sustaining this infection.

Patient was a 12-year-old boy who with no prior medical history who was sent to the emergency department from an outpatient ophthalmology clinic due to concern for papillitis on exam. He had a three-week history of right eye pain and a one-week history of progressive vision loss, describing a dark spot in the center of his vision that was expanding. He was urgently taken to MRI which was unremarkable. A lumbar puncture was preformed which was notable for an opening pressure of 30, although the CSF studies were unremarkable. Upon admission to the hospital, pediatric ophthalmology examined the patient and noted swelling and exudates that were consistent with cat scratch disease.

We present a rare case of pediatric Bartonella neuroretinitis with additional manifestations of cat scratch disease including right eye pain and progressive vision loss and known contact with cats. Bartonella neuroretinitis is important to include in a differential diagnosis of a pediatric patient presenting with vision changes and should be started on empiric antibiotics as soon as the infection is suspected. Early evaluation and timely treatment are essential to prevent vision loss and poor outcomes.

Publication Date

5-8-2026

Disciplines

Emergency Medicine

Recommended Citation

McCarthy K, Young G, Gunnink S. A rare case of pediatric Bartonella neuroretinitis. Presented at: Research Day Corewell Health West; 2026 May 8; Grand Rapids, MI. Presented at: Research Day Corewell Health West; 2026 May 8; Grand Rapids, MI.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2072