Cat-Scratch Disease with Treatment

This is a 35-year-old male veterinarian who complained of experiencing blurred vision over several days. His visual acuity at initial visit was 20/70 in both eyes. He had macular subretinal fluid on the right, optic disc swelling on the left, and a mid-peripheral locus of retinitis on the left. Blood testing for Bartonella henselae was positive. Testing for syphilis. Toxoplasmosis, and tuberculosis was negative. In his optical coherence tomography (OCT) scans, there was intraretinal fluid in both eyes (yellow arrows). Optic disc swelling (white arrow), subretinal fluid and hemorrhage (blue arrow) are also visible in the color fundus photos. Retinitis is present nasally on the left (red arrow). After treatment with rifampin, the fundus picture improved with return of 20/20 visual acuity in both eyes (5/25/2018 images).