zithromax and Retinitis

Topics: Administration, Oral; Adult; Azithromycin; Ceftriaxone; Drug Therapy, Combination; Erythromycin; Eye Infections, Bacterial; Humans; Injections, Intravenous; Legionella longbeachae; Legionellosis; Male; Retinitis; Scotoma; Tomography, Optical Coherence; Visual Acuity

Bartonella henselae, the cause of cat-scratch disease in humans, may lead to characteristic vision-threatening ocular findings, which importantly indicate diagnosis.. This is an observational case report of a 6-year-old boy who presented with bilateral stellate maculopathy and lymphadenopathy.. After serologic verification of B. henselae infection, systemic azithromycin therapy initiated the full recovery of visual acuity and bilateral complete resolution of stellate exudates during the following months.. Stellate maculopathy should always include the differential diagnosis of B. henselae infection. In this rare case of bilateral stellate maculopathy, we observed full recovery of function following systemic macrolide therapy.

Topics: Animals; Anti-Bacterial Agents; Azithromycin; Bartonella henselae; Cat-Scratch Disease; Cats; Child; Diagnosis, Differential; Eye Infections, Bacterial; Humans; Macula Lutea; Male; Retinitis; Treatment Outcome; Visual Acuity

Cat scratch neuroretinitis (CSN) is a clinical diagnosis supported by serological testing. We present 2 cases of CSN in which initial acute titers were negative or equivocal for Bartonella henselae while convalescent titers were shown to be positive. We report these cases to emphasize that a single acute negative titer is insufficient to exclude the diagnosis of CSN and that convalescent titers should be obtained in patients for whom there is a high clinical suspicion of the disease.

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Bartonella henselae; Cat-Scratch Disease; Child; Female; Humans; Immunoglobulin G; Magnetic Resonance Imaging; Male; Retinitis

Cat-scratch disease is one of several diseases known to be caused by Bartonella species. Some infections due to Bartonella resolve spontaneously without treatment with antibiotics, but in other cases the disease can be fatal without treatment. This case study reports a 7-year-old male who presented with an unexplained encephalopathy and unusual retinal findings associated with evidence supporting infection by B. henselae. The 7-year-old male presented with a 2-week history of general malaise and cervical lymphadenopathy progressing onto fever, headache, vomiting, and confusion associated with meningism. Lumbar puncture revealed a raised cerebrospinal fluid protein, low glucose, and raised white cell count. Abnormal retinal findings and raised antibodies titres to B. quintana indicated a diagnosis of cat-scratch disease. He was treated with azithromycin orally for 3 weeks and made a complete recovery.

Topics: Anti-Bacterial Agents; Azithromycin; Bartonella Infections; Bartonella quintana; Brain; Brain Damage, Chronic; Cat-Scratch Disease; Child; Diagnosis, Differential; Fever; Humans; Male; Retinitis

To investigate the efficacy of azithromycin in patients with ocular toxoplasmosis.. 11 immunocompetent patients with ocular toxoplasmosis were treated with azithromycin (500 mg the first day, followed by 250 mg/day for 5 weeks). Ocular and systemic examinations were performed during active retinitis episodes and all patients were followed for at least 1 year.. The intraocular inflammation disappeared within 4 weeks in seven patients, including two cases with progressive retinitis despite previous treatment with pyrimethamine, sulphadiazine, and folinic acid. Recurrence of retinitis occurred in three patients (27%) within the first year of follow up. No systemic side effects of azithromycin were encountered.. These results indicate that although azithromycin cannot prevent recurrent disease it may be an effective alternative for patients with ocular toxoplasmosis who cannot tolerate standard therapies.

Topics: Adult; Aged; Anti-Bacterial Agents; Azithromycin; Female; Follow-Up Studies; Humans; Male; Middle Aged; Recurrence; Retinitis; Toxoplasmosis, Ocular; Treatment Failure; Uveitis, Anterior