The answer to this month’s mystery image: 

Cat-Scratch Disease

This 12-year-old boy presented with a droopy upper eyelid. There also was a several-week history of mild irritation with discharge and cervical lymphadenopathy. On further questioning, we learned that the patient had recently been caring for a new litter of kittens. Examination showed a granulomatous follicular conjunctivitis, and biopsy of the left upper lid lesion revealed suppurative granulomatous inflammation consistent with cat-scratch disease. Serology was positive for elevated IgG titers for Bartonella henselae.

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Blink is edited by Richard E. Hackel, MA, CRA