A 24-year-old veterinary student with a kitten at home presents with painless blurred vision in one eye. Fundus examination shows optic disc swelling with radiating stellate exudates around the macula. There is mild preauricular lymphadenopathy ipsilateral to a recent cat scratch. The most likely diagnosis is:

• A Toxoplasmic retinochoroiditis
• B Diabetic papillopathy
• C Syphilitic posterior uveitis
• D Cat scratch disease neuroretinitis ✓

Explanation

Bartonella henselae is the commonest infectious cause of neuroretinitis, defined as optic disc oedema with a macular star figure formed by radially arranged lipid exudates. It typically follows cat scratch disease and may accompany regional lymphadenopathy or Parinaud oculoglandular syndrome. Toxoplasma retinochoroiditis produces focal necrotising retinal lesions adjacent to old scars rather than a macular star, and syphilis causes panuveitis without this fundus pattern.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.