A 58-year-old female had right eye redness, swelling, and right preauricular lymphadenopathy for 3 weeks. Vision was 6/9 bilaterally. The right eye was proptosed with swollen eyelid. The extraocular movements restricted with conjunctiva chemosis. Fundus was unremarkable. Her white cell count and CRP raised. Intravenous Ceftriaxone was started for orbital cellulitis. A computed tomography brain and orbit showed no collection but revealed right lower eyelid enhancing mass. Histopathology of the mass showed necrotizing granulomatous inflammation consistent with Bartonella infection. Diagnosis was revised to Parinaud oculoglandular syndrome, and the patient received 6-week course of oral cefuroxime.
Zaki et al. (2026) studied this question.