Parinaud oculoglandular syndrome (POS) manifests as a unilateral granulomatous conjunctivitis associated with preauricular and submandibular adenopathy. The adenopathy can be very marked (Fig 16-5). Cat-scratch disease is the most common cause of POS. Other causative organisms include Mycobacterium tuberculosis, Mycobacterium leprae, Francisella tularensis, Yersinia pseudotuberculosis, T pallidum, and C trachomatis.
Cat-scratch disease is usually associated with a scratch from a young kitten, although a cat bite and perhaps even touching the eye with a hand that has been licked by an infected kitten can cause the disease. The etiologic agent, which is endemic in cats, is Bartonella henselae, a pleomorphic gram-negative bacillus.
Diagnosis is made on clinical grounds and supported by a compatible history of exposure to cats. An immunofluorescent assay directed at B henselae is available.
Treatment can be supportive in mild cases because the disease is self-limited and is not known to cause corneal complications. In more severe cases, systemic antibiotics may be considered, although an optimal treatment has not been identified.