Cases reported "uveitis, suppurative"

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1/3. iris nodules associated with infectious uveitis.

    BACKGROUND/AIM: iris nodules are an uncommon clinical sign in uveitis. The diseases most commonly associated with iris nodules and uveitis include sarcoidosis, Vogt-Koyanagi-Harada syndrome, multiple sclerosis, Fuchs' heterochromic iridocyclitis, and metastatic infection. While many of these diseases may be appropriately treated with immunosuppressive medication, the management of infectious uveitis is antimicrobial therapy. Inappropriate immunosuppressive therapy may result in a poor outcome for the patient with an infection. Consequently, cases of uveitis with iris nodules were reviewed to identify clinical features that may help differentiate infection from non-infectious inflammation. methods: The clinical database of 1353 consecutive patients evaluated at a tertiary care referral based North American uveitis clinic were retrospectively reviewed to identify cases of infectious uveitis with iris nodules. A medline search was performed to identify additional cases. From these cases information regarding clinical presentation, diagnosis, treatment, and outcome were collected. RESULTS: Three cases (three eyes) were identified from the authors' own records of infectious uveitis with iris nodules. An additional 25 cases of infectious uveitis with iris nodules were identified in 22 published reports. Analysis of the authors' cases and these reports showed that infectious uveitis with iris nodules was specifically characterised by some or all of the following: (1) creamy, soft appearance to the nodule(s), (2) unilateral disease, (3) persistence or growth of the nodule(s) despite corticosteroid therapy, (4) marked inflammatory response in the anterior chamber and/or vitreous humour, and/or (5) history suggesting a potential source of septic emboli. CONCLUSION: Certain features of the clinical history and examination are useful in the diagnosis of metastatic infection in patients presenting with uveitis and iris nodules. ( info)

2/3. Hypopyon uveitis associated with systemic lupus erythematosus and antiphospholipid antibody syndrome.

    PURPOSE: To report a case of hypopyon uveitis associated with systemic lupus erythematosus and antiphospholipid antibody syndrome. methods: Interventional case report: a 49-year-old woman with a history of systemic lupus erythematosus and antiphospholipid antibody syndrome presented with sudden onset of pain, redness, photophobia, and decreased vision in the left eye. Examination revealed hypopyon uveitis and vaso-occlusive retinopathy. RESULTS: Following treatment with intravenous steroids and cyclophosphamide, the patient's vision improved from CF to 20/80 with no inflammation 6 months following initial presentation. CONCLUSIONS: In this case, systemic lupus and antiphospholipid syndrome were associated with hypopyon uveitis. Prompt treatment with systemic immunosuppressive therapy resulted in improvement in the hypopyon uveitis and vaso-occlusive retinopathy. ( info)

3/3. Acute uveitis associated with rifabutin use in patients with human immunodeficiency virus infection.

    PURPOSE: We studied patients with a new anterior uveitis syndrome associated with rifabutin use. methods: Nine patients with the acquired immunodeficiency syndrome (AIDS) who developed acute anterior uveitis were identified retrospectively from institutional ophthalmology, infectious disease, and AIDS primary care practices. Five patients initially had hypopyon; in three patients hypopyon was bilateral and recurrent. The medical history, initial signs and symptoms, diagnostic examination, clinical course, and response to therapy were ascertained by a review of the medical records. RESULTS: All nine patients were being treated with rifabutin for treatment of, or prophylaxis against, mycobacterium avium complex. In no patient was another untreated cause of uveitis found. In each patient the uveitis resolved rapidly without sequelae with treatment with topical corticosteroids alone. In eight patients uveitis resolved completely while treatment or prophylaxis for M. avium complex was maintained. CONCLUSIONS: We studied a new hypopyon uveitis syndrome in patients with AIDS who are being treated with rifabutin. The interaction of multiple drugs may contribute to this uveitis syndrome. This uveitis is remarkable because it is fulminant yet responds rapidly to topical corticosteroids. Characterization of this syndrome is important because hypopyon in the immunocompromised patient generally mandates intensive, and sometimes invasive, ophthalmic and systemic examination and therapy. Additional study is required to determine whether immune status, underlying infection, or drug-related factors contribute to the development of this uveitis syndrome. Although this syndrome remains a diagnosis of exclusion, ophthalmologists must be aware of it, so that intervention is guided appropriately. ( info)


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