Branch retinal artery occlusion secondary to Bartonella hens
The patient presented with a sudden, unilateral, and painless scotoma. Fundoscopic findings and multimodal imaging were consistent with a BRAO with associated areas of intraretinal whitening along the involved artery. Upon further questioning, the patient reported having 15 cats at home. Antibodies were positive for B. henselae. The patient was treated with oral doxycycline 100 mg twice daily for 2 months with complete resolution of the retinal findings and the scotoma.

Specific to this patient's case, clearance of the focal retinitis and complete resolution of symptoms were noted after treatment with oral doxycycline. While Eiger-Moscovich et al.5 were unable to clearly show a beneficial therapeutic effect with doxycycline in their small case series of Bartonella associated BRAO, This case suggests the potential benefit of doxycycline alone in these cases. Further larger studies would be helpful to define management in this specific clinical scenario, although this is difficult in such a rare condition. This case should alert clinicians to the possibility of B. henselae as a potential cause of retinitis and BRAO in patients, even young children.

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