Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"


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Abstract
Abstract

Oculo-Glandular Conjunctivitis Associated with Cat-scratch Disease

Künster A.1, Emmerich K. H.1, Jeckel M.2
1Dept. of Ophthalmology, 2Dept. for Treatment of Ear, Nose and Throat Diseases, Municipal Hospital Darmstadt

Purpose: Cat-scratch disease is an often self-limiting granulomatous disease associated with local lymphadenopathy, which can also affect the eye and its adnexa. It is caused by a rickettsia-like bacterium called Bartonella henselae, which enters the organism through a skin lesion caused by cats. Characteristically an unilateral lid swelling with partially exulcerating subtarsal granulomas ca be seen, a conjunctivitis with chemosis and swelling of the regionary lymph nodes in the preauricular and submandibular region. A rare complication is a neuroretinitis with typical papilledema and macular exsudates.
Method: Diagnosis can be made by biopsy of conjunctival granulomas, lymph nodes or by PCR from secretion as well as by serological tests (ELISA). Therapy consists of systemic and local administration of antibiotics as Ciprofloxacin, Doxycycline, Erythromycin or Rifampicin. In some cases excision of granulomas can be advisable.
Results: We report about a 12-year-old boy who suffered from painful unilateral lid swelling and lymphadenopathy. Serology confirmed the presumed diagnosis.
Conclusions: The differential diagnosis of oculo-glandular conjunctivitis is discussed.


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