Unusual manifestations occur in 11 to 12% of patients: Parinaud oculoglandular syndrome (conjunctivitis associated with palpable preauricular nodes) in 6% Neurologic manifestations (encephalopathy, seizures, neuroretinitis [causes acute unilateral vision loss], myelitis, paraplegia, cerebral arteritis) in 2% Hepatosplenic granulomatous disease in < 1% Patients may also present with a fever of unknown origin.