Suspecting optic neuritis, diagnosing Bartonella cat scratch disease.

BACKGROUND Bartonella cat scratch disease is classically a febrile illness, in conjunction with lymphadenopathy and cat exposure. OBJECTIVE To report 2 atypical cases of cat scratch disease with only blurred vision and headache. DESIGN Case reports. SETTING University hospital. PATIENTS Two young adults with unilateral blurred vision, retro-orbital headache, and a positive Bartonella henselae serologic result, without fever or lymphadenopathy. MAIN OUTCOME MEASURES Funduscopic examination and B henselae serologic findings. RESULTS Both patients had optic disc swelling and a macular star on funduscopic examination, suggestive of infection. Infection was confirmed by positive serologic results. CONCLUSION Cat scratch disease should be considered in the differential diagnosis for patients presenting with blurred vision and headache, even in the absence of fever, lymphadenopathy, or both.