To characterize cases of sporotrichosis presenting as Parinaud's oculoglandular syndrome (POS).
Methods
Retrospective review of medical charts/laboratory results of patients with POS presenting at our emergency eye care facility.
Results
Ten patients with POS were identified, aged 8-47 years, with four females. Most presented with persistent conjunctival hyperemia/mucoid discharge. These had been treated with topical corticosteroids/antibiotics/saline irrigation, with no improvement. One patient had a two-month history of progressive unilateral cervical/preauricular lymphadenopathy, concerning for lymphoma. He was then hospitalized and referred for ophthalmology assessment. Examination revealed unilateral mild conjunctival hyperemia, marked follicular reaction, tarsal conjunctival granulomas and ipsilateral preauricular lymphadenopathy in all cases. Eight patients showed mucoid discharge, and only one had bulbar conjunctival granulomas. All patients reported contact with domestic cats. Six had been scratched by cats that exhibited skin lesions suggestive of sporotrichosis. Conjunctival scrapings were taken for microbial culture, and itraconazole 100mg bid was initiated for all cases. After one month of treatment, all patients had symptomatic improvement, although granulomas could be found until after 16 weeks of therapy. Sporothrix sp. was cultured from 4/10 cases (40%).
Conclusion
Sporotrichosis is reemerging in Brazil, representing the leading etiology of POS, in contrast to Bartonella. Early clinical presentation may overlap with viral conjunctivitis, complicating diagnosis. Definitive fungal isolation is by culture on Sabouraud agar, and antifungal therapy is often maintained for a long period, until two weeks after resolution of granulomas.
Conflict of interest
No
1
Last name
FREIRE
Initials of first name(s)
BCC
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
City
BELO HORIZONTE
Country
Brazil
2
Last name
GUIMARÃES
Initials of first name(s)
GB
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
City
Belo Horizonte
Country
Brazil
3
Last name
VIANA
Initials of first name(s)
LE
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
City
Belo Horizonte
Country
Brazil
4
Last name
Otoni
Initials of first name(s)
YFM
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
City
Belo Horizonte
Country
Brazil
5
Last name
VASCONCELOS-SANTOS
Initials of first name(s)
DV
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil 2 Fac
City
Belo Horizonte
Country
Brazil
This website uses cookies to ensure you get the best experience on our website.
Learn more