Cases reported "Uveitis, Anterior"

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1/9. sarcoidosis-related anterior uveitis in a patient with human immunodeficiency virus.

    BACKGROUND: This is the first ophthalmic report--to our knowledge--of an anterior uveitis secondary to sarcoidosis in a patient infected with human immunodeficiency virus (hiv). Other reported causes of uveitis in hiv-infected patients have included hiv, herpes zoster, tuberculosis, syphilis, toxoplasmosis, cryptococcus, rifabutin prophylaxis for mycobacterium, and protease inhibitors such as ritonavir and indinavir. uveitis secondary to sarcoidosis in the non-hiv population is classically seen in young, female, African-American patients. There are rare reports, found exclusively in the pulmonary literature, of sarcoidosis in hiv-infected patients. CASE REPORT: A 38-year-old African-American male infected with hiv was treated for chronic recurrent anterior uveitis secondary to sarcoidosis. His sarcoidosis was diagnosed 1 month earlier, along with the onset of his uveitis. During the previous 6 years he has been treated with anti-hiv antivirals as well as prophylaxis for opportunistic infections. To date, his infectious disease specialist continues to treat his hiv and systemic sarcoidosis. CONCLUSION: patients with hiv infection in whom sarcoidosis with secondary uveitis develops are very rare. Management of these patients requires careful use of topical and oral steroidal anti-inflammatories to control ocular and systemic sequelae of sarcoidosis. This case initiates some interesting questions about the immunology of sarcoidosis and its presence in immunocompromised patients. Use of steroids in an immunocompromised patient is clinically complex. Further clinical study is needed to elicit the full clinical significance of sarcoidosis and hiv infection.
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keywords = mycobacterium
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2/9. rifabutin-induced uveitis with inflammatory vitreous infiltrate.

    PURPOSE: To describe an ocular complication of rifabutin therapy in the treatment of mycobacterium avium complex (MAC) infection in the absence of hiv infection or AIDS. methods: Three patients on rifabutin therapy for MAC chest infection developed anterior uveitis with vitreous infiltrates. The clinical course and visual outcome are discussed. RESULTS: The ocular signs of anterior segment inflammation along with vitreous infiltrate resolved on topical steroid therapy without long-term visual sequelae. CONCLUSION: This report highlights the potential of uveitis in patients treated for MAC infection with rifabutin without concurrent hiv infection or AIDS.
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ranking = 1.8000265251012
keywords = avium
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3/9. 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 = 3.6000530502024
keywords = avium
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4/9. uveitis associated with rifabutin therapy.

    PURPOSE: To highlight the association of uveitis with the use of rifabutin. methods: Retrospective study of two patients with acute anterior uveitis. RESULTS: Both patients were receiving rifabutin for treatment of atypical Mycobacterium infection associated with AIDS when they developed unilateral acute anterior uveitis and arthritis. The inflammation resolved and vision improved with introduction of topical corticosteroids, mydriatics and cessation of rifabutin treatment. CONCLUSION: Use of rifabutin with clarithromycin may precipitate acute uveitis in patients with AIDS being treated for systemic mycobacterium avium complex infection. uveitis produced by rifabutin may be analogous to Herxeimer reaction as seen in syphilis. clarithromycin and fluconazole elevate levels of rifabutin due to inhibition of metabolism through cytochrome p-450 pathway. The differential diagnosis includes Reiter's syndrome, syphilis causing uveitis, metastatic endophthalmitis, and direct hiv-related uveitis.
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ranking = 1.8000265251012
keywords = avium
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5/9. 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.
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ranking = 3.6000530502024
keywords = avium
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6/9. 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 = 9.0001326255061
keywords = avium
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7/9. rifabutin-associated anterior uveitis in patients infected with human immunodeficiency virus.

    iridocyclitis, arthralgia, and pseudojaundice have been identified as dose-dependent adverse effects in patients with acquired immunodeficiency syndrome (AIDS) who are treated orally with rifabutin for Mycobacterium avium intracellulare complex (MAC) infections. Nine episodes of acute anterior uveitis of varying severity ranging from mild iridocyclitis to anterior uveitis with fibrin or hypopyon, mimicking endogenous metastatic endophthalmitis, occurred in seven patients. At the time of presentation, all seven patients were receiving rifabutin at a dose ranging from 300 to 600 mg daily. iridocyclitis was bilateral in four of seven patients, in two cases simultaneously and in two cases successively. inflammation resolved rapidly on treatment with systemic and topical antibiotics, on corticosteroid therapy, and on discontinuation of rifabutin. In two cases of mild iridocyclitis, cessation of rifabutin alone led to resolution of the uveitis. The combination of rifabutin, clarithromycin, and fluconazole may increase the risk for anterior uveitis in patients with AIDS. All of our patients were treated with fluconazole, with clarithromycin, or with a combination of both substances in addition to rifabutin. Identification of rifabutin-induced uveitis is important because hypopyon uveitis in the immunocompromised patient generally evokes intensive and, sometimes, invasive ophthalmic and systemic workup and therapy. We suggest it to be sufficient for resolution of the inflammatory signs to discontinue rifabutin medication.
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ranking = 1.8000265251012
keywords = avium
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8/9. Recurrent bilateral anterior uveitis with hypopyon and rifabutin therapy.

    rifabutin is used in patients with human immunodeficiency virus infection to prevent and treat mycobacterium avium complex infection. We report a case of recurrent bilateral anterior uveitis with hypopyon in a patient who was taking 600 mg of rifabutin daily. The rate of recurrence with the continuation of rifabutin seems to be high, especially in the opposite eye (alternate uveitis with hypopyon); rifabutin should be discontinued if uveitis recurs.
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ranking = 1.8000265251012
keywords = avium
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9/9. uveitis associated with rifabutin therapy: a clinical alert.

    BACKGROUND: The incidence of mycobacterium avium complex (MAC) infection is increasing among patients with AIDS. rifabutin therapy has been demonstrated to be effective in the treatment and prophylaxis of MAC infection. over the past 3 years there have been several reports of uveitis associated with rifabutin therapy. The uveitis is almost always interior, begins unilaterally and progresses to involve both eyes. There is almost always a hypopyon present, and the uveitis progresses aggressively. It responds well to conventional treatment along with the discontinuance of rifabutin. methods/RESULTS: This paper presents a new case of rifabutin uveitis and a review of the various published reports to date. CONCLUSIONS: All primary eye care clinicians should be aware of this new and unique clinical presentation and be prepared to recognize it quickly and treat it appropriately.
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ranking = 1.8000265251012
keywords = avium
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