Parinaud's oculoglandular syndrome: Coinfection by Bartonella henselae and Sporothrix brasiliensis

• Published in: Acta tropica 2024-09, Vol.257, p.107297, Article 107297
• Main Authors: Suzuki, Natalia Naomi, Mitsuushi, Gabriela Nero, dos Santos, Luciene Silva, Souza, Lais Bomediano, Cintra, Maria Letícia, Zaninelli, Angélica, Velho, Paulo Eduardo Neves Ferreira, Drummond, Marina Rovani
• Format: Article
• Language: English
• Subjects: Adult; Animals; Anti-Bacterial Agents - therapeutic use; azithromycin; Azithromycin - therapeutic use; Bartonella henselae; Bartonella henselae - genetics; Bartonella henselae - isolation & purification; biopsy; blood sampling; cat scratch disease; Cat-Scratch Disease - complications; Cat-Scratch Disease - diagnosis; Cat-Scratch Disease - drug therapy; Cat-Scratch Disease - microbiology; Cats; Coinfection - microbiology; DNA; doxycycline; Doxycycline - therapeutic use; eyelids; Female; Humans; itraconazole; Itraconazole - therapeutic use; lymph nodes; mixed infection; Parinaud's oculoglandular syndrome; polymerase chain reaction; Skin - microbiology; Skin - pathology; skin lesions; Sporothrix - genetics; Sporothrix - isolation & purification; Sporothrix schenckii; Sporotrichosis; Sporotrichosis - diagnosis; Sporotrichosis - drug therapy; Sporotrichosis - microbiology; women; zoonoses
• ISSN: 0001-706X; 1873-6254; 1873-6254
• DOI: 10.1016/j.actatropica.2024.107297

•Patients can have Sporothrix schenckii complex and Bartonella henselae infections at the same time.•A cat may be the source of both fungal and bacterial infections.•Patients who present skin lesion and/or Parinaud's oculoglandular syndrome after cat bites or scratches should be initially examined for both cat scratch disease and sporotrichosis.•More studies are needed with regard to the role of Bartonella henselae infection in human mycoses such as sporotrichosis. A 26-year-old woman presented an eyelid lesion, after being scratched by a cat that had a similar skin lesion. It evolved into a cervical lymph node enlargement. With a hypothesis of Parinaud´s oculoglandular syndrome (POS) due to cat scratch disease (CSD), doxycycline was prescribed. After two weeks of treatment without improvement, a biopsy and blood sample were obtained. Itraconazole was prescribed and the skin lesion improved, but not the lymph node enlargement. A Sporothrix schenckii complex was isolated from the skin sample. Also, a specie-specific polymerase chain reaction detected Bartonella henselae DNA in her blood sample. Azithromycin was included to treat the bacterial infection, whereupon the lymph node also receded successfully. Sporotrichosis and CSD are zoonoses that can be transmitted to humans by traumatic inoculation due to scratches or bites from cats. Both can evolve with POS. Patients who present skin lesions and/or POS after being wounded by a cat should be investigated for both diseases.