Parinaud's oculoglandular syndrome: Coinfection by Bartonella henselae and Sporothrix brasiliensis

Acta Trop. 2024 Sep:257:107297. doi: 10.1016/j.actatropica.2024.107297. Epub 2024 Jun 22.

Abstract

A 26-year-old woman presented an eyelid lesion, after being scratched by a cat that had a similar skin lesion. It evolved into a cervical lymph node enlargement. With a hypothesis of Parinaud´s oculoglandular syndrome (POS) due to cat scratch disease (CSD), doxycycline was prescribed. After two weeks of treatment without improvement, a biopsy and blood sample were obtained. Itraconazole was prescribed and the skin lesion improved, but not the lymph node enlargement. A Sporothrix schenckii complex was isolated from the skin sample. Also, a specie-specific polymerase chain reaction detected Bartonella henselae DNA in her blood sample. Azithromycin was included to treat the bacterial infection, whereupon the lymph node also receded successfully. Sporotrichosis and CSD are zoonoses that can be transmitted to humans by traumatic inoculation due to scratches or bites from cats. Both can evolve with POS. Patients who present skin lesions and/or POS after being wounded by a cat should be investigated for both diseases.

Keywords: Bartonella henselae; Parinaud's oculoglandular syndrome; Sporotrichosis.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adult
  • Animals
  • Anti-Bacterial Agents* / therapeutic use
  • Azithromycin / therapeutic use
  • Bartonella henselae* / genetics
  • Bartonella henselae* / isolation & purification
  • Cat-Scratch Disease* / complications
  • Cat-Scratch Disease* / diagnosis
  • Cat-Scratch Disease* / drug therapy
  • Cat-Scratch Disease* / microbiology
  • Cats
  • Coinfection* / microbiology
  • Doxycycline / therapeutic use
  • Female
  • Humans
  • Itraconazole / therapeutic use
  • Skin / microbiology
  • Skin / pathology
  • Sporothrix* / genetics
  • Sporothrix* / isolation & purification
  • Sporotrichosis* / diagnosis
  • Sporotrichosis* / drug therapy
  • Sporotrichosis* / microbiology

Substances

  • Anti-Bacterial Agents
  • Azithromycin
  • Itraconazole
  • Doxycycline

Supplementary concepts

  • Sporothrix brasiliensis