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Parinaud oculoglandular syndrome

Parinaud oculoglandular syndrome is an eye problem that is similar to conjunctivitis ("pink eye"). It usually affects only one eye and occurs with swollen lymph nodes and an illness with a fever.

Note: Parinaud syndrome is a different disorder in which you are unable to look up. This can be caused by a brain tumor, and requires an immediate evaluation by your health care provider.

Alternative Names

Cat-scratch disease; Oculoglandular syndrome

Causes, incidence, and risk factors

Parinaud oculoglandular syndrome (POS) is caused by an infection by bacteria, virus, fungus, or a parasite.

The most common causes are cat-scratch disease and tularemia (rabbit fever). The bacteria that cause either condition can infect the eye. Either the bacteria can directly enter the eye (on a finger or other object), or air droplets that carry the bacteria can land on the eye.

Other infectious diseases may spread this same way, or through the bloodstream to the eye.

Symptoms

  • Red, irritated, and painful eye (looks like "pink eye")
  • Fever
  • General ill-feeling
  • Increased tearing (possible)
  • Swelling of nearby lymph glands (often in front of the ear)

Signs and tests

An examination shows:

  • Fever and other signs of illness
  • Red, tender, inflamed eye
  • Tender lymph nodes may be present in front of the ear
  • There may be growths (conjunctival nodules) on the inside of the eylid or the white of the eye

Blood tests will be done to check for infection. A white blood cell count may be high or low, depending on the cause of the infection.

Blood tests to check antibody levels is the main method used to diagnose many of the infections that cause POS. Other tests may include:

Treatment

Depending on the cause of the infection, antibiotics may be helpful. Surgery may be necessary in rare cases to clean away the infected tissues.

Expectations (prognosis)

The outlook depends on the cause of the infection. In general, if the diagnosis is made early and treatment starts immediately, the outcome of POS can be very good.

Complications

Serious complications are rare.

The conjunctival nodules can sometimes form sores (ulcers) during the healing process. The infection can spread to nearby tissues or into the bloodstream.

Calling your health care provider

You should call your health care provider if you develop a red, irritated, painful eye.

Prevention

Frequent hand washing can reduce the likelihood of getting POS. Avoid being scratched by a cat, even a healthy cat. You can avoid tularemia by not having contact with wild rabbits, squirrels, or ticks.

References

Tu EY. Parinaud's oculoglandular syndrome. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. On DVD-ROM. 1st ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2012:chap 4.

Rolain JM, Raoult D. Bartonella infections. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 323.

Updated: 9/3/2012

Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


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