An Unusual Presentation of Multifocal Choroiditis in Ocular Bartonellosis

Abstract

A 38-year-old woman was admitted with a complaint of decreased vision in the right eye for 4 days. Fundus examination of the right eye revealed optic disc edema and macular elevation. Optical coherence tomography (OCT) of the right eye showed a choroidal volcanic confi guration and subretinal fl uid at the macular area and the peripapillary region. The fl uorescein angiographic examination of the right eye revealed a lesion with early hypofl uorescence and late hyperfl uorescence with leakage, also hyperfl uorescence at the optic disc. Regression of volcanic confi guration in section through the macula and newly developed choroidal volcanic confi guration in sections passing through above the macula was detected in OCT 3 weeks after the fi rst visit. Laboratory investigations showed raised IgM and IgG titres for Bartonella henselae. Rifampicin and doxycyclin were administered orally. Subretinal fl uid and chorioretinal signs disappeared over the ensuing 1 month. Bartonella involves posterior segment in various clinical forms. In our case, choroidal involvement was presented as shifting foci of choroiditis. To keep this clinical form of multifocal choroiditis in mind may be helpful to identify these lesions and to suggest ocular bartonellosis within differential diagnosis when observed prior to serological diagnosis.