trimethoprim--sulfamethoxazole-drug-combination and Uveitis--Anterior

In this case report we present a female patient with recurrent urinary infection treated with trimethoprim/sulfamethoxazole, trimethoprim alone and ciprofloxacin. She developed adverse systemic symptoms and bilateral anterior uveitis following administration of the former two drugs, and in addition retinal haemorrhages after the use of trimethoprim. Uveitis and retinal haemorrhages are rare side effects of trimethoprim/sulfamethoxazole. To our best knowledge they have not been described as a side effect of trimethoprim alone.

Topics: Administration, Topical; Adult; Anti-Infective Agents, Urinary; Ciprofloxacin; Drug Therapy, Combination; Female; Follow-Up Studies; Glucocorticoids; Humans; Ophthalmic Solutions; Recurrence; Retinal Hemorrhage; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections; Uveitis, Anterior

PATIENTS AND METHODS We present a 57-year-old white man with progressive deterioration of vision, who had a prolonged history of weakness, migratory arthralgias and loss of weight. Bilateral panuveitis, with iritis, inflammatory vitreous opacities associated with small, round, grayish retinal lesions. The duodenum showed a swollen mucosa, which was flecked over with pinpoint grayish grains. A small-bowel biopsy disclosed PAS-positive granules in the macrophages of the lamina propria mucosa, pathognomonic of Whipple's disease. RESULTS After antibiotic treatment with trimethoprim and sulfamethoxazole there was no relapse of the panuveitis during the follow-up period of 18 months.

Topics: Humans; Intestinal Mucosa; Male; Middle Aged; Ophthalmoscopy; Retina; Retinal Diseases; Trimethoprim, Sulfamethoxazole Drug Combination; Uveitis, Anterior; Vitreous Body; Whipple Disease