Parinaud's syndrome is an eye problem similar to conjunctivitis ("pink eye") which usually affects only one eye and is accompanied by nearby swollen lymph nodes and an illness with a fever.
Causes, incidence, and risk factors
Many different infections can cause Parinaud's syndrome, including bacteria, viruses, fungi and parasites. The most common causes are tularemia (rabbit fever) and cat-scratch fever. Tularemia can infect the eye either by direct inoculation of the bacteria into the eye (by a finger or other object) or via aerosolization of the bacteria into the air, which then land on the eye. Other infectious diseases can spread both by these mechanisms and also through the bloodstream to the eye.
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. These lymph nodes can fester, depending on the cause of the infection. A fever and other signs of generalized illness may also be found. The white blood cell count may be high or low, depending on the cause of the infection. For many of the infections that cause Parinaud's syndrome, blood tests to check antibody levels are the main methods used to make a diagnosis. Sometimes, culture of the eye, lymph node, or blood or biopsy of the lymph node can be helpful.
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 underlying infection. In general, if the diagnosis is made early and prompt treatment is begun, the outcome of Parinaud's syndrome can be very good.
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's syndrome. Specifically, tularemia can be avoided by not having contact with wild rabbits, squirrels or ticks. Cat scratch disease is usually a self-limited, acute illness associated with lymphadenopathy, fatigue, headache, and anorexia. It is more likely transmitted by young kittens.