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1/4. rifabutin-associated hypopyon uveitis in human immunodeficiency virus-negative immunocompetent individuals.

    OBJECTIVE: To report the occurrence of rifabutin-associated hypopyon uveitis in human immunodeficiency virus (hiv)-negative immunocompetent individuals. DESIGN: Retrospective case series. PARTICIPANTS: Three hiv-negative subjects on rifabutin and clarithromycin for mycobacterium avium complex infections with hypopyon uveitis are described. One subject was iatrogenically immunosuppressed because of a prior lung transplant. Two subjects had no known immunosuppressive conditions. INTERVENTION: Topical and regional steroid therapy. Discontinuation of rifabutin was required in two subjects. MAIN OUTCOME MEASURES: visual acuity, resolution of hypopyon, anterior uveitis, and vitreitis. RESULTS: All subjects had resolution of hypopyon after therapy, two within 24 hours of beginning topical steroids. Vitreitis resolved with the discontinuation of rifabutin in two subjects. Chronic low-grade anterior uveitis and vitreitis were observed in the remaining subject, whose rifabutin dose was lowered but not discontinued because of active mycobacterium avium complex osteomyelitis. CONCLUSIONS: rifabutin-associated uveitis is well described in hiv-positive individuals, but it has been reported only once in an hiv-negative individual. We report two cases of hypopyon uveitis in immunocompetent individuals and one case in an immunosuppressed hiv-negative individual. All three subjects were receiving concurrent rifabutin and clarithromycin. awareness that this entity can occur in hiv negative and nonimmunosuppressed individuals and that it can mimic infectious endophthalmitis may spare the subject from an invasive workup of systemic infection.
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ranking = 1
keywords = avium
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2/4. Suppurative cervical adenitis caused by opportunist mycobacterium.

    Of 45 consecutive submandibular abscesses treated by external drainage in a district oral surgery unit, four cases, representing nearly 9% of the sample, were caused by opportunist Mycobacterium avian-intracellulare, an organism known to give a poor response to all known antimycobacterial chemotherapeutic agents. Treatment by excision of the diseased tissue is indicated in these cases. The diagnosis and management of these conditions is discussed.
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ranking = 1.2710474596101
keywords = mycobacterium
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3/4. Hypopyon uveitis in patients with acquired immunodeficiency syndrome treated for systemic mycobacterium avium complex infection with rifabutin.

    OBJECTIVE: iridocyclitis has been identified as a dosage-dependent side effect in patients with the acquired immunodeficiency syndrome (AIDS) who are treated for mycobacterium avium complex (MAC) infection with systemic rifabutin. We reviewed cases of acute hypopyon uveitis occurring in patients with AIDS to establish whether there was an association. DESIGN: Retrospective case series. SETTING: Outpatient clinic and inpatient hospital-based ophthalmology referral practice and infectious disease specialty service. patients: Seven patients with AIDS, aged 10 to 40 years, presenting with acute unilateral hypopyon mimicking infectious endophthalmitis. MAIN OUTCOME MEASURES: Findings from complete ophthalmological evaluation and ancillary laboratory testing. RESULTS: At the time of presentation, all seven patients were receiving treatment for MAC infection with rifabutin (dosage range, 300 to 600 mg/d) and clarithromycin. Results of microbiological investigations in five patients were negative. iridocyclitis became bilateral in all seven patients, and hypopyon developed in the contralateral eye in five of seven patients. Hypopyon resolved rapidly with intensive topical corticosteroid therapy. Residual inflammation responded to topical corticosteroids with or without reduction of the rifabutin dosage. CONCLUSIONS: Concomitant use of rifabutin, clarithromycin, and fluconazole may precipitate hypopyon uveitis in patients with AIDS being treated for MAC infection.
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ranking = 2.5
keywords = avium
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4/4. Oral mycobacterium avium complex infection in a patient with hiv-related disease. A case report.

    mycobacterium avium complex infection is a common complication of the later stages of AIDS. Although a recognized cause of oral lesions, atypical mycobacteria are rarely detected in AIDS-related oral ulceration. Here we report a case of oral ulceration in a patient in the later stages of AIDS in which atypical mycobacteria were detected both histologically and microbiologically. The features of this case are similar to the one other case previously reported permitting some characterization and comparison of the clinical features of mycobacterium avium complex infection in AIDS.
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ranking = 16.152858080342
keywords = mycobacterium avium, avium, mycobacterium
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