77 Document heading doi: 10.1016/S2222-1808(14)60631-9 襃 2015 by the Asian Pacific Journal of Tropical Disease. All rights reserved. Unilateral visual loss secondary to cat scratch disease in a healthy young man Norfarizal Ashikin Abdullah, Umi Kalthum Md Noh * , Rona Asnida Nasaruddin, Ayesha Md Zain, Hanizasuriana Hashim, Jemaima Che Hamzah Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia Asian Pac J Trop Dis 2015; 5(1): 77-79 Asian Pacific Journal of Tropical Disease journal homepage: www.elsevier.com/locate/apjtd *Corresponding author: Umi Kalthum Md Noh, Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia. E-mail: umi_fizul@yahoo.com 1. Introduction Cat scratch disease (CSD) caused by Bartonella henselae (B. henselae) is one of the etiology for neuroretinitis [1] . Almost 33% of patients who had exposure to cats will have serologic evidence of previous B. henselae infection. During the initial stages, patients may present with lesion at the inoculation site, followed by painful lymphadenopathy of the draining lymph node. These presentations are usually accompanied by constitutional symptoms such as malaise, fever and myalgia which were common in CSD but uncommon in recurrence cases [2] . However, the diagnosis of CSD is not precluded by the absence of history of cat bite [3] . Although there are many species of Bartonella, B. henselae is a Gram negative bacillus known to be the major causative agent of CSD. This particular strain induce retinal infection with classical presentations of necrotizing granulomatous lesions seen typically in immunocompetent patients [4-6] . This case report illustrates a serologically proven case of CSD in an immunocompetent male which responded well to treatment. 2. Case report A 36-year-old healthy young man had presented with gradual worsening of central vision in the left eye for a month. He had history of recurrent low grade fever that was associated with myalgia. He has three healthy and well kept cats at home. He sustained minor abrasion while handling PEER REVIEW ABSTRACT KEYWORDS Cat scratch disease, Bartonella henselae, Immunocompetent Cat scratch disease is a benign clinical syndrome manifested as lymphadenopathy, fever and sometimes with atypical symptom of blurring of vision. It occurs following cat’s bites or scratches. This case report presented a healthy young man presented with left eye blurring of vision for 1 month duration preceeded by history of recurrent low grade fever with previous history of being scratched by cat. Examination revealed optic disc edema with macula star. Thorough investigations were done and shown positive titre towards Bartonella henselae. He responded well with intravenous ceftazidime, oral doxycycline and rifampicin. His vision improved to 6/9 and 6/6 with pinhole after 3 months. Contents lists available at ScienceDirect Peer reviewer Wan Hazabbah Wan Hitam, Senior Lecturer, Consultant Ophthalmologist & Neuro-ophthalmologist, Department of Ophthalmology, School of Medical Sciences, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia. Tel: +609-767 6361/6362 Fax: +609-765 3370 E-mail: hazabbah@usm.my hazabbah@yahoo.com Comments Overall, this is a good case report. The topic is interesting and well written. It is important to share the clinical presentation and the management of this case. Proper treatment will hasten the recovery and prevent further complication. Details on Page 79 Article history: Received 21 Apr 2014 Received in revised form 27 Apr, 2nd revised form 5 May, 3rd revised form 12 May 2014 Accepted 15 Jun 2014 Available online 11 Jul 2014