Conservative Management of Eyelid Necrotizing Fasciitis in a Pediatric Patient With Concurrent Parinaud’s Oculoglandular Syndrome

Parinaud's oculoglandular syndrome is an uncommon manifestation of Bartonella henselae infection presenting with granulomatous conjunctivitis, marked preauricular lymphadenopathy, and occasional necrotizing lesions. The most common cause of Parinaud's oculoglandular syndrome is due to direct contact with contaminated cat saliva or scratches near the eye. While Parinaud's oculoglandular syndrome has been linked to cat scratch disease, it has not been associated with necrotizing soft tissue infections due to a distinct bacterial process, such as necrotizing fasciitis due to Group A Streptococcus. We present a pediatric patient who was coinfected with Bartonella henselae and Group A Streptococcus and presented clinically with both Parinaud's oculoglandular syndrome and necrotizing fasciitis. The patient was successfully treated with antibiotics without surgical debridement.