A 58-year-old patient with no family history of interest and personal history of pharmacologically controlled arterial hypertension for 6 years and maxillary sinusitis for 10 days without specific treatment.
He came to the emergency department with foot and vision distortion in the left eye (LE) for several days.
The maximum visual acuity in the right eye (OD) was 1 and in the left eye 0.125, the intrinsic ocular motility were normal, the study with a slit lamp showed no pathology.
Funduscopic examination in the right eye was normal but in the left eye there was a serous macular detachment extending to the superior and inferior temporal vessels, the optic nerve and the rest of the parenchymal alterations.
A cat was stuck on the left thigh two weeks before the loss of vision.
Seven days after being explored by us, he developed painful erythematous lesions limited to the lower extremities consistent with erythema nodosum that, within 20-25 days, were ulcerated.
Consultation to the internal medicine service was held for a shared study.
The chest X-ray was normal, the sinus x-ray showed mild sinus congestion in the left maxillary sinus.
Serological studies: ANA, ANCA, antiphospholipid ac were normal.
Serology CMV, EBV, Ritsias, Toxoplasma, HIV, Lyme and serology were negative.
Mantoux was also negative.
Blood count: Leukocytes 20.670, ESR 64 mm 1st h, PCR 16.4 mg/L. IgM serological levels against B. Henselae by ELISA were positive at 1:812.
The patient was treated with ciprofloxacin 1 gram per day for 14 days.
Four weeks after the treatment, the patient's condition began to return and the systemic manifestations resolved, achieving a visual acuity of the unit.
