Parinaud syndrome

Definition

Parinaud syndrome is an eye problem similar to conjunctivitis ("pink eye"). It usually affects only one eye and is accompanied by nearby swollen lymph nodes and an illness with a fever.

Causes, incidence, and risk factors

Parinaud syndrome is caused by an infection by bacteria, virus, fungus, or parasite.

The most common causes are tularemia (rabbit fever) and cat-scratch fever. Tularemia can infect the eye either by direct entry of the bacteria into the eye (on a finger or other object), or by air droplets that carry the bacteria, and then land on the eye.

Other infectious diseases may spread this same way, or through the bloodstream to the eye.

Symptoms

• Red, irritated, and painful eye (looks like "pink eye")
• Fever
• General ill-feeling
• Increased tearing (possible)
• Swelling of nearby lymph glands (often in front of the ear)

Signs and tests

An examination shows a red, tender, inflamed eye with possible ulcers in the cornea (surface). Tender lymph nodes may be present in front of the ear. You may have a fever and other signs of illness.

Blood tests will be done to check for infection. A white blood cell count may be high or low, depending on the cause of the infection.

Blood tests to check antibody levels are the main methods used to diagnose many of the infections that cause Parinaud syndrom. Other tests may include a biopsy of the lymph node and laboratory culture of eye secretions, lymph node tissue, or blood.

Treatment

Depending on the cause of the infection, antibiotics may be helpful. Surgery may be necessary to clean away the infected tissues.

Expectations (prognosis)

The outlook depends on the cause of the infection. In general, if the diagnosis is made early and treatment starts immediately, the outcome of Parinaud syndrome can be very good.

Complications

Eye complications can lead to blindness. The infection can spread to nearby tissues or into the bloodstream.

Calling your health care provider

You should call your health care provider if you develop a red, irritated, painful eye.

Prevention

Frequent hand washing can reduce the likelihood of acquiring Parinaud syndrome. Specifically, tularemia can be avoided by not having contact with wild rabbits, squirrels, or ticks.