zithromax and Uveitis

To identify predictors of treatment success in syphilitic uveitis (SU).. Retrospective multicentric analysis of patients treated for SU.. A total of 95 eyes (66 patients, mean [standard deviation] aged 49 [12.5] years, 31 [47%] of whom were human immunodeficiency virus [HIV]+) were analyzed.. Activity of SU was assessed at 1 week and 1 month after treatment onset, and at last follow-up. Improvement was defined by a ≥2-step decrease of both anterior chamber and vitreous haze inflammation levels, and by the size reduction in chorioretinal lesions.. Recovery was defined as the resolution of inflammation in all anatomic structures at 1 month.. Panuveitis and posterior uveitis were the most frequent findings. Inflammatory parameters were higher in HIV+ patients. Recovery was reported in 65% and 85% of eyes at 1 month and at last follow-up, respectively. In multivariate analysis, after adjusting for initial best-corrected visual acuity and the antimicrobial treatment regimen, clinical improvement at 1 week (corrected risk ratios [cRR], 3.5 [2.3-3.8]; P = 0.001) was predictive of recovery at 1 month, whereas the use of periocular dexamethasone injections (cRR, 0.05 [0.02-0.6]; P = 0.01) and methylprednisolone pulses negatively affected the outcomes of eyes.. Early improvement is the strongest predictor of ophthalmological recovery in SU.

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Doxycycline; Eye Infections, Bacterial; Female; Fluorescent Treponemal Antibody-Absorption Test; Follow-Up Studies; HIV Seropositivity; Humans; Male; Middle Aged; Penicillin G Benzathine; Polymerase Chain Reaction; Prognosis; Retrospective Studies; Sulfadiazine; Syphilis; Syphilis Serodiagnosis; Uveitis; Visual Acuity

Ocular toxoplasmosis may present in atypical fashion, particularly in immunosuppressed patients, and PCR is an important diagnostic tool especially when differentiating from other infectious causes.. A descriptive case-series demonstrating the use of a novel real-time PCR protocol targeting 529 bp repeat element, a multicopy and highly conserved fragment, in Toxoplasma gondii genome. This was designed and established by our microbiology service following independent, external validation.. Three immunosuppressed patients presenting to a tertiary uveitis referral centre with unilateral, severe, sight-threatening uveitis are described. One patient presented with a large focus of sight-threatening retinitis and occlusive vasculitis while on systemic immunosuppression with azathioprine and adalimumab for Crohn's disease. One patient with chronic lymphocytic leukaemia presented with severe posterior uveitis and total retinal detachment. Finally, the third patient presented with severe retinitis adjacent to the optic nerve and vitritis causing acute vision loss. HIV infection was subsequently identified. In all three cases, the cause of inflammation was not clear from clinical examination alone and prompt treatment was required to prevent permanent vision loss. Intraocular sampling and PCR testing was performed including testing for toxoplasmosis, herpesviruses and syphilis.. The novel real-time PCR assay described is more sensitive than those targeting the Toxoplasma B1 gene owing to the higher number of repeats and highly conserved sequence level. This technique can be applied in clinical practice and provides a valuable tool for the rapid diagnosis of ocular toxoplasmosis.

Topics: Aged; Azithromycin; Base Pairing; DNA Primers; DNA Probes; DNA, Protozoan; Drug Combinations; Eye Infections, Parasitic; Female; Humans; Immunosuppressive Agents; Male; Middle Aged; Prednisolone; Real-Time Polymerase Chain Reaction; Repetitive Sequences, Nucleic Acid; Toxoplasma; Toxoplasmosis, Ocular; Trimethoprim, Sulfamethoxazole Drug Combination; Uveitis; Vitreous Body

Topics: Adolescent; Adult; Anti-Bacterial Agents; Antibodies, Bacterial; Azithromycin; Diagnosis, Differential; Eye Infections, Bacterial; Female; Fluorescein Angiography; Glucocorticoids; Humans; Immunoglobulin G; Immunoglobulin M; Male; Mycoplasma pneumoniae; Papilledema; Pneumonia, Mycoplasma; Prednisone; Tomography, Optical Coherence; Uveitis; Young Adult

Serum sickness is immune response to a foreign antigen, usually a heterologous protein. Incidence rate is less than 0.5%. Antigens and responding antibodies form circulating immunocomplex that is characteristic for serum sickness. The condition occurs 7-15 days after exposure to the antigen, usually with clinical picture of glomerulonephritis. The immunocomplex circulates to other tissues where it sediments and causes inflammation, such as arteritis, neuritis, synovitis. The aim of this research is to present the break out of serum sickness in form of anterior uveitis due to azithromycin therapy administered by mouth. Identifying of anterior uveitis may help in early diagnostics and treatment of serum sickness.

Topics: Anti-Bacterial Agents; Azithromycin; Child; Humans; Male; Serum Sickness; Uveitis

Topics: Azithromycin; Clarithromycin; Drug Resistance, Microbial; Drug Therapy, Combination; HIV Infections; Humans; Mycobacterium avium-intracellulare Infection; Rifabutin; Uveitis

Disseminated Mycobacterium avium complex (DMAC) is the third most common opportunistic infection in people with AIDS, infecting up to 50 percent of them. Symptoms include high fever, weight loss, fatigue, diarrhea, poor appetite, night sweats, and anemia. Diagnosis is by blood culture. Results of two recent studies are presented, as well as treatment guidelines issued by a national panel.

Topics: AIDS-Related Opportunistic Infections; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antibiotics, Antitubercular; Antifungal Agents; Azithromycin; Clarithromycin; Clinical Trials as Topic; Dexamethasone; Drug Interactions; Drug Resistance, Microbial; Drug Therapy, Combination; Ethambutol; Fluconazole; Humans; Mycobacterium avium-intracellulare Infection; Rifabutin; Risk Factors; Uveitis