Presumed Oculoglandular Syndrome from Bartonella quintana

Abstract

Background: To describe a case of clinically diagnosed oculoglandular syndrome in a 17-year-old patient that was presumed to be due to Bartonella quintana, as suggested by a positive serologic titer. Methods: The patient presented to the Massachusetts Eye and Ear Infirmary emergency room with signs and symptoms suggestive of oculoglandular syndrome. He had a follicular conjunctivitis with a conjunctival granuloma of the right eye and an ipsilateral large, tender submandibular lymph node. He had recently acquired a kitten and a clinical diagnosis of cat-scratch disease was made. A laboratory workup was initiated to determine the cause of this clinical presentation and empirical treatment with antibiotics was started. Results: All laboratory results were negative or normal except for the IgM titer to Bartonella quintana, which was elevated. The patient responded well to treatment and his symptoms resolved within a few weeks. Discussion: Bartonella quintana infection, a pathogen prevalent in HIV-infected, homeless, or alcoholic patients, is a possible etiologic agent of cat-scratch disease and the associated condition of oculoglandular syndrome.

KEYWORDS:

• Oculoglandular
• Bartonella