oculoglandular

Oculoglandular (often referred to as Parinaud oculoglandular syndrome) is a clinical presentation in which inflammation of the eye is accompanied by regional lymph node swelling on the same side. It is most commonly described as unilateral granulomatous conjunctivitis with ipsilateral preauricular or submandibular lymphadenopathy, and it is typically infectious in origin.

Most cases are associated with Bartonella henselae, the agent of cat scratch disease. Other infectious etiologies have been reported, including Francisella tularensis (tularemia), Mycobacterium species, Chlamydia trachomatis, and less commonly other bacteria or fungi. Exposure history, such as contact with cats or other animals, can support the diagnosis.

Clinical features usually include mild to moderate eyelid and conjunctival inflammation, a granulomatous or nodular conjunctival lesion, tearing, and unilateral ocular discomfort. Ipsilateral lymphadenopathy is often tender and readily palpable, sometimes appearing days to weeks after the onset of conjunctivitis. Vision is typically preserved; systemic symptoms may be mild or absent.

Diagnosis rests on clinical recognition and history, supported by laboratory testing when indicated. Serology or PCR for Bartonella henselae can aid in confirming cat scratch disease; additional tests may be pursued to identify other etiologies or to exclude other causes of conjunctivitis and lymphadenopathy.

Treatment is frequently supportive, as many cases are self-limited. When Bartonella infection is suspected or confirmed, antibiotics active against Bartonella (for example, azithromycin; doxycycline in adults; caution with doxycycline in young children) may hasten resolution. Management of other etiologies follows standard infectious disease guidelines. The prognosis is generally favorable, with most patients recovering within several weeks to months.