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[Acute hypopyon uveitis with rifabutin therapy of systemic Mycobacterium avium complex (MAC) infection in AIDS]
U C Schaller1, G Michl, F D Goebel
1Augenklinik, Universität München.
Background:
Hypopyon-uveitis has been identified as a dosage-dependent side effect in patients with acquired immunodeficiency syndrome who are treated for Mycobacterium avium complex (MAC) infection with systemic rifabutin.
Patients And Methods:
We report a 38-year-old female AIDS patient with bilateral hypopyon uveitis under therapy with rifabutin in combination with clarithromycin and indinavir.
Results:
At the time of presentation of the bilateral hypopyon uveitis the patient was treated with rifabutin (300 mg/day), clarithromycin (1000 mg/day) and ethambutol (1000 mg/day) for an M. avium complex infection. Also, the patient received the protease inhibitor indinavir. The rifabutin dose was reduced to 150 mg/day. Hypopyon and inflammation resolved under therapy with steroids.
Conclusions:
The concomitant use of rifabutin, clarithromycin, and protease inhibitors may lead to hypopyon uveitis. Reduction of dosage of rifabutin (150 mg/day) and treatment with topical steroids are required.
Insights
Hypopyon-uveitis is a potential side effect of rifabutin treatment for Mycobacterium avium complex (MAC) infection in AIDS patients. Reducing rifabutin dosage and using steroids can resolve this condition.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Pharmacology
Background:
- Hypopyon-uveitis is a known dosage-dependent adverse effect in acquired immunodeficiency syndrome (AIDS) patients treated with rifabutin for Mycobacterium avium complex (MAC) infections.
- Rifabutin is a key antibiotic in treating MAC infections, but its ocular side effects require careful management.
Observation:
- A 38-year-old female with AIDS presented with bilateral hypopyon uveitis.
- The patient was concurrently receiving rifabutin (300 mg/day), clarithromycin, ethambutol, and the protease inhibitor indinavir for MAC infection.
Findings:
- Reducing the rifabutin dosage to 150 mg/day led to the resolution of hypopyon and inflammation.
- The patient's condition improved with the addition of topical steroid therapy.
Implications:
- Concomitant use of rifabutin, clarithromycin, and protease inhibitors may increase the risk of hypopyon uveitis.
- Dosage adjustment of rifabutin and corticosteroid treatment are crucial for managing this ocular side effect.