A 36-year-old male consults for conjunctival hyperemia and foreign body sensation. Which of the following pathologies does NOT correspond to the above mentioned examination?
The involvement of the preauricular node is the typical lymphadenopathy of conjunctival infectious conditions. It is true that typical bacterial conjunctivitis does not usually present with lymphadenopathy. They have a more rapid and self-resolving course and do not awaken the lymphoid response as adenoviruses typically do. Or some more atypical bacteria that produce chronic conjunctivitis, such as Chlamydia, or much more infrequent bacteria such as those responsible for Parinaud's oculoglandular syndrome (Bartonella henselae, Francisella tularensis, Sporothrix schenckii, etc). Adenopathy being very typical of adenoviral conjunctivitis, this option is the easiest to rule out. Considering that chlamydiae arouse the lymphoid response in a similar way to adenoviruses (they also produce conjunctival follicles, for example), this would be the second easiest option to rule out. Perhaps the difficult thing is to rule out oculoglandular syndrome of Parinaud, because it is a very rare disease. If we do not realize that it is an infectious disease, we could hesitate. In any case, allergic conjunctivitis is not an infectious problem. So it is not going to have adenopathy. Even if we doubt with some of the previous options (especially with Parinaud), if we stay with the basic concepts (allergic conjunctivitis does not present with lymphadenopathies) we can be right. Option 2 is the correct one.
Adenoviral conjunctivitis.
Allergic conjunctivitis.
Parinaud's oculoglandular syndrome.
Chlamydia conjunctivitis.
Adenopathy being very typical of adenoviral conjunctivitis, this option is the easiest to rule out.
Even if we doubt with some of the previous options (especially with Parinaud), if we stay with the basic concepts (allergic conjunctivitis does not present with lymphadenopathies) we can be right. Option 2 is the correct one.
In any case, allergic conjunctivitis is not an infectious problem. So it is not going to have adenopathy.
Considering that chlamydiae arouse the lymphoid response in a similar way to adenoviruses (they also produce conjunctival follicles, for example), this would be the second easiest option to rule out.