Course: Unilateral Conjunctivitis With Multifocal Granulomatous Lesions in a Child Aged 10 Years
CME Credits: 1.00
Released: 2023-06-15
A 10-year-old previously healthy female child presented with 1 month of left eye redness and irritation. She had been using ofloxacin eye drops for 2 weeks with continued worsening. On examination, the right eye was normal. The left eye had a granulomatous conjunctivitis with follicles (). Dilated examination of both eyes was normal. She had left preauricular lymphadenopathy. She reported recent contact with cats. Serology was positive for Bartonella henselae immunoglobulin G (titer of 1:256), which confirmed the diagnosis of Parinaud oculoglandular syndrome (POGS). She was treated with doxycycline, 100 mg, by mouth twice a day and rifampin, 300 mg, by mouth twice a day for 14 days, with resolution of the granulomatous lesions after 7 days. POGS is a unilateral granulomatous conjunctivitis with ipsilateral lymphadenopathy typically caused by Bartonella henselae; rare causes include Francisella tularensis and Mycobacterium tuberculosis, among others.- This case was striking due to the prominent multifocal conjunctival granulomas and the rapid resolution after initiation of appropriate therapy.
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