rifampin and Uveitis--Posterior

A three-month old baby girl presented with fever of unknown origin and with signs of worsening of this episode. Funduscopy showed a solitary choroidal lesion in her left eye, as well as extraocular lesions suggesting disseminated tuberculosis. A favourable outcome was achieved after quadruple antibiotic course and cortisone therapy. Disseminated tuberculosis should be considered in cases of fever of unknown origin in children with an unsatisfactory evolution. Ocular examination is mandatory, due to the possible posterior uveitis signs that can help with early diagnosis and treatment of some diseases.

Topics: Adrenal Cortex Hormones; Amikacin; Antitubercular Agents; Choroid Diseases; Drug Therapy, Combination; Ethambutol; Female; Humans; Infant; Isoniazid; Ophthalmoscopy; Pyrazinamide; Rifampin; Tuberculoma; Tuberculosis, Miliary; Tuberculosis, Ocular; Uveitis, Posterior

To determine the level of agreement with the presumed diagnosis and long term clinical outcomes after antituberculous therapy (ATT) in a group of patients with presumed tuberculous uveitis (PTU) affecting the posterior segment.. Retrospective case series.. A total of 17 patients with chronic refractory or newly diagnosed uveitis affecting the posterior segment were included. All included patients were diagnosed with PTU and received ATT. Median follow-up after ATT was 34 months (range 2-60). Complete control of inflammation was observed in 14/17 patients (82.3%) during the treatment period, and only 4/17 patients (23.5%) had a uveitis relapse over the entire follow-up period after ATT. All patients who had uveitis relapses (4/4), but none from the remaining group (0/13), required immunosuppressive therapy of some kind after ATT. The response to ATT was able to confirm diagnosis of PTU in 14/17 (82.3%) included patients.. When a clinical suspicion of PTU affecting the posterior segment exists, ATT may be highly effective for both confirming the diagnosis and resolving the inflammatory process. Thus, ATT may offer additional advantages, such as preventing latent-tuberculosis reactivations due to immunosuppressive therapy, and decreasing the number and/or severity of uveitis relapses in some patients. Prospective, randomized studies including a larger number of patients are required to support these and other potential advantages of ATT in such patients.

Topics: Anti-Bacterial Agents; Antitubercular Agents; Drug Therapy, Combination; Humans; Immunocompromised Host; Immunosuppressive Agents; Isoniazid; Panuveitis; Pyrazinamide; Recurrence; Remission Induction; Retrospective Studies; Rifampin; Treatment Outcome; Tuberculosis, Ocular; Uveitis, Posterior

A 30-year-old-lady, (Case 1) was found to have brucella uveitis in her left eye. Serum agglutination (SAT) and SAT/Coombs titers were positive at 1:320 and 1:160, respectively. In Case 2, a 12-year-old-girl diagnosis of left brucellosis uveitis was made. Both SAT and SAT/Coombs titers were positive at 1:1280. This report confirms that Brucellae organisms as a cause of uveitis.

Topics: Adult; Agglutination Tests; Brucellosis; Child; Coombs Test; Doxycycline; Drug Therapy, Combination; Eye Infections, Bacterial; Female; Humans; Panuveitis; Prednisolone; Rifampin; Tetracycline; Uveitis, Posterior