rifampin and Optic-Neuritis

Topics: Aminosalicylic Acid; Antitubercular Agents; Blood-Brain Barrier; Chemical and Drug Induced Liver Injury; Drug Therapy, Combination; Ethambutol; Humans; Injections, Spinal; Isoniazid; Optic Neuritis; Rifampin; Streptomycin; Tuberculosis, Meningeal

Topics: Chemical and Drug Induced Liver Injury; Costs and Cost Analysis; Drug Eruptions; Drug Resistance, Microbial; Ethambutol; Humans; Liver; Optic Neuritis; Rifampin; Thioacetazone; Tuberculosis

A 30-year-old man experienced subacute peripheral visual field loss with preserved central vision in his right eye. He was diagnosed with optic perineuritis due to tuberculosis. Optic perineuritis is an uncommon disorder and, at times, can be difficult to distinguish from optic neuritis. The differentiation can have significant impact on diagnostic testing and patient management.

Topics: Adult; Antitubercular Agents; Bronchoscopy; Drug Therapy, Combination; Humans; Isoniazid; Magnetic Resonance Imaging; Male; Optic Neuritis; Pyrazinamide; Rifampin; Tuberculosis, Pulmonary; Vision Disorders; Visual Acuity; Visual Fields

Topics: Adolescent; Anti-Bacterial Agents; Antibodies, Bacterial; Bartonella henselae; Cat-Scratch Disease; Doxycycline; Drug Therapy, Combination; Eye Infections, Bacterial; Humans; Immunoglobulin G; Immunoglobulin M; Male; Optic Neuritis; Rifampin; Tomography, Optical Coherence; Vision Disorders

Topics: Adult; Anti-Bacterial Agents; Antibodies, Bacterial; Bartonella henselae; Cat-Scratch Disease; Doxycycline; Drug Therapy, Combination; Eye Diseases; Eye Infections, Bacterial; Female; Fluorescein Angiography; Glucocorticoids; Humans; Immunoglobulin G; Optic Neuritis; Prednisone; Retinal Detachment; Retinitis; Rifampin; Tomography, Optical Coherence; Vision Disorders; Visual Acuity; Visual Fields; Vitrectomy; Vitreous Body

Mycobacterial infection in an organ transplant recipient is a diagnostic and therapeutic challenge. Diagnosis is often delayed, resulting in significant morbidity. Anti-microbial chemotherapy needs careful selection to prevent potentially significant complications, such as organ rejection and dose-related toxicities. We present the case of a 61-year-old Caucasian male kidney transplant recipient with chronic tenosynovitis of the left wrist. Histological findings of the synovial biopsy revealed multinucleated giant cell epithelioid granuloma. Culture of synovial fluid grew Mycobacterium kansasii. Treatment with rifampicin, ethambutol, and clarithromycin proved curative, but the patient developed irreversible ethambutol-related optic neuritis.

Topics: Clarithromycin; Ethambutol; Humans; Kidney Transplantation; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Mycobacterium kansasii; Optic Neuritis; Rifampin; Tenosynovitis; Wrist

Tuberculosis is an endemic disease responsible for death and morbidity in developing countries.. A 50-year-old man with no medical history was admitted to the emergency department for meningism associated with fever and confusion. The ophthalmic exam showed a decline in left visual acuity, reduced to light perception, VIth nerve left oculomotor paralysis, ocular fundus demonstrating a yellow tumor located on the posterior segment, measuring 1.5-2mm, papillomatous and prominent in the vitreous cavity. Fluorescein angiography showed a peritumoral choroiditis area, miliary tubercles of the choroid, and sectorial papillomatous edema. Color retinography unmasked inflamed posterior vitreous areas. Echography demonstrated a 4- to 5-mm oval hyperechogeneous and calcified tumor along with hyperechogeneous vitreous areas. Lumbar puncture showed lymphocytic meningitis associated with hyponatremia. The CT scan and MRI demonstrated optic neuritis. The antibiotic therapy was initiated and the outcome was favorable.. This case report shows the importance of systematic ocular fundus in the presence of systemic tuberculosis and outlines the assessment of color retinography to unmask vitreous lesions. It shows the importance of radiological imaging in the semiological study of orbital and cerebral lesions.

Topics: Adrenal Cortex Hormones; Anti-Inflammatory Agents; Antitubercular Agents; Calcinosis; Confusion; Diplopia; Drug Therapy, Combination; Fever; Humans; Isoniazid; Magnetic Resonance Imaging; Male; Meningoencephalitis; Middle Aged; Optic Neuritis; Papilledema; Pyrazinamide; Rifampin; Spinal Puncture; Streptomycin; Tuberculoma; Tuberculosis, Meningeal; Ultrasonography

The characteristic clinical presentation of cat scratch disease is subacute regional lymphadenopathy; nevertheless, 5-25% of Bartonella henselae infections may present an atypical or systemic form, with potential eye involvement. We describe three clinical cases of ocular bartonellosis in two adolescents and one young adult, who had close contact with cats; all of them presented persistent fever ranging from 15 to 21 days, and two of them developed a sudden unilateral loss of visual acuity associated with optic neuritis. The other patient presented retinal choroiditis and unilateral retinal microgranulomas, with normal visual acuity. Patients received macrolides as sole antimicrobial or in association with rifampin, and one patient was additionally treated with systemic corticoids. The outcome was favorable in two patients; one patient developed a permanent visual deficit. Ocular bartonellosis must be suspected in patients with close contact to cats or with cat scratches whom develop persistent fever and sudden loss of visual acuity.

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Bartonella henselae; Cat-Scratch Disease; Child; Choroid Diseases; Eye Infections, Bacterial; Female; Humans; Male; Optic Neuritis; Retinal Diseases; Rifampin; Visual Acuity

It has been suggested that Chlamydia pneumoniae (C. pneumoniae) is involved in the pathogenesis of diverse diseases of the central nervous system (CNS), including multiple sclerosis. We report the case of a 12-year-old male with isolated recurrent optic neuritis and an associated CNS infection with C. pneumoniae. The patient presented with three attacks of optic neuritis within 5 months. A positive polymerase chain reaction for C. pneumoniae in the cerebrospinal fluid led to the diagnosis of a CNS infection with C. pneumoniae. After treatment with the antibiotic rifampicin, he experienced no further attacks during the follow-up period of 6 years. These findings suggest the possibility of a C. pneumoniae infection as a contributing factor or even causative event for the development of optic neuritis.

Topics: Antibiotics, Antitubercular; Central Nervous System Diseases; Child; Chlamydophila Infections; Chlamydophila pneumoniae; Humans; Male; Optic Neuritis; Rifampin; Treatment Outcome

Topics: Adult; Antitubercular Agents; Combined Modality Therapy; Drug Therapy, Combination; Ethambutol; Hemianopsia; Humans; Isoniazid; Kidney Failure, Chronic; Male; Optic Neuritis; Renal Dialysis; Rifampin; Tuberculosis

Topics: Acetamides; Aged; Anti-Infective Agents; Antibiotics, Antitubercular; Ciprofloxacin; Female; Functional Laterality; Humans; Linezolid; Optic Neuritis; Oxazolidinones; Prosthesis-Related Infections; Rifampin

Topics: Bartonella henselae; Cat-Scratch Disease; Doxycycline; Drug Therapy, Combination; Eye Infections, Bacterial; Humans; Optic Neuritis; Retinitis; Rifampin

To report atypical clinical features of Bartonella henselae neuroretinitis treated with combination antibiotics.. Case report.. A 20-year-old man with a positive B. henselae titer developed a unilateral neuroretinitis, a large peripapillary angiomatous lesion, branch artery occlusion with ischemic maculopathy, and vision loss that failed to improve with clindamycin. Treatment with doxycycline and rifampin led to rapid clinical improvement. The severe vision loss in this case is atypical.. Ocular findings associated with B. henselae infection may include retinal angiomatous lesion and branch retinal artery occlusion. Doxycycline and rifampin were successful in treating the infection.

Topics: Adult; Antibodies, Bacterial; Bartonella henselae; Blindness; Cat-Scratch Disease; Doxycycline; Drug Therapy, Combination; Enzyme-Linked Immunosorbent Assay; Eye Infections, Bacterial; Fluorescein Angiography; Fundus Oculi; Hemangioma, Capillary; Humans; Male; Optic Neuritis; Retinal Artery Occlusion; Retinal Neoplasms; Retinal Vessels; Retinitis; Rifampin; Visual Acuity

This study aimed to report the long-term outcomes of patients treated with an antibiotic drug combination for Bartonella henselae neuroretinitis.. The study design was a retrospective case series.. Seven consecutive patients with neuroretinitis and cat scratch disease participated.. Patients underwent medical and ophthalmic evaluations. Blood cultures were obtained, and B. henselae antibody titers were measured. Tuberculosis, Lyme, toxoplasmosis, syphilis, and sarcoidosis were excluded. Patients received oral doxycycline 100 mg and rifampin 300 mg twice daily for 4 to 6 weeks and were observed for an average of 16 months (range, 10-24 months). Formal electrophysiologic testing was performed in three patients after resolution of neuroretinitis.. The changes in ocular inflammation and visual function associated with treatment were recorded. Follow-up examinations and electrophysiologic testing documented sequelae.. Patients presented following cat exposure with fever, malaise, and blurred vision. Decreased visual acuity (ranging from 20/40 to counting fingers) frequently was associated with dyschromatopsia and afferent pupillary defects. Ophthalmoscopic analysis showed signs of neuroretinitis, including nerve fiber layer hemorrhages, cotton-wool spots, multiple discrete lesions in the deep retina, and stellate macular exudates. B. henselae infection was confirmed with positive blood cultures or elevated immunofluorescent antibody titers or both. Therapy appeared to promote resolution of neuroretinitis, restoration of visual acuity, and clearance of bacteremia. After 1 to 2 years, two eyes had residual disc pallor, afferent pupillary defects, retinal pigmentary changes, and mildly decreased visual acuity. Electrophysiologic studies showed that when compared to the fellow eye, affected eyes had subnormal contrast sensitivity, abnormal color vision, and abnormal visually evoked potentials. Conversely, electroretinograms were normal in all subjects.. B. henselae is a cause of neuroretinitis in cat scratch disease. Compared to historic cases, doxycycline and rifampin appeared to shorten the course of disease and hasten visual recovery. Long-term prognosis is good, but some individuals may acquire a mild postinfectious optic neuropathy.

Topics: Adult; Antibodies, Bacterial; Bartonella henselae; Cat-Scratch Disease; Color Perception; Contrast Sensitivity; Doxycycline; Drug Therapy, Combination; Electroretinography; Evoked Potentials, Visual; Eye Infections, Bacterial; Female; Fluorescein Angiography; Fundus Oculi; Humans; Male; Optic Neuritis; Retinitis; Retrospective Studies; Rifampin; Visual Acuity

Topics: Adult; Animals; Antibiotics, Antitubercular; Antibodies, Bacterial; Bartonella henselae; Cat-Scratch Disease; Cats; Ceftriaxone; Cephalosporins; Encephalitis; Eye Infections, Bacterial; Humans; Magnetic Resonance Imaging; Male; Optic Neuritis; Retinitis; Rifampin

Topics: Antitubercular Agents; Body Weight; Dose-Response Relationship, Drug; Drug Combinations; Ethambutol; Humans; Isoniazid; Optic Neuritis; Practice Guidelines as Topic; Pyrazinamide; Rifampin; South Africa; Streptomycin; Tuberculosis

Topics: Adult; Age Factors; Aged; Antitubercular Agents; Aspartate Aminotransferases; Chemical and Drug Induced Liver Injury; Drug Evaluation; Ethambutol; Humans; Isoniazid; Kidney Diseases; Middle Aged; Optic Neuritis; Rifampin; Risk; Streptomycin; Tuberculosis

Topics: Adult; Aminosalicylic Acid; Antitubercular Agents; Central Nervous System Diseases; Chemical and Drug Induced Liver Injury; Child; Drug Interactions; Ethambutol; Female; Humans; Immunosuppression Therapy; Isoniazid; Optic Neuritis; Phenytoin; Pregnancy; Rifampin; Streptomycin; Thrombocytopenia

The rate of acetylation of isoniazid is usually constant in a given subject. The authors report here a case where despite an adjusted initial dose there was a decrease in the rate of acetylation during treatment with INH-rifampicin and ethambutol, without hepatic involvement but accompanied by retrobulbar optic neuritis. The role of ethambutol and/or an overdose of isoniazid are discussed. The technique for its estimation is also described.

Topics: Acetylation; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Liver; Male; Optic Neuritis; Rifampin; Tuberculosis

Topics: Aged; Capreomycin; Electroretinography; Ethambutol; Humans; Male; Optic Atrophy; Optic Neuritis; Rifampin; Scotoma; Time Factors; Tuberculosis, Pulmonary; Visual Fields; Vitamin B Complex

Topics: Capreomycin; Cells, Cultured; Chemical and Drug Induced Liver Injury; Cycloserine; Depression; Drug Hypersensitivity; Drug Resistance, Microbial; Drug Therapy, Combination; Ethambutol; Follow-Up Studies; Hospitalization; Humans; Isoniazid; Kanamycin; Kidney Diseases; Optic Neuritis; Patient Education as Topic; Rifampin; Streptomycin; Tuberculosis, Pulmonary

Topics: Adult; Aged; Chorioretinitis; Choroiditis; Eye Diseases; Female; Humans; Male; Middle Aged; Optic Neuritis; Retinitis; Rifampin; Tuberculosis, Ocular; Uveitis; Uveitis, Anterior