UVEITIS WITH HYPOPYON IN PATIENTS WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME TREATED WITH RIFABUTIN

Background Iridocyclitis has been identified as a dosage-dependant sid e effect in patients with the acquired immunodeficiency syndrome who a re treated for Mycobacterium avium complex: infections with systemic R ifabutin. We reviewed cases of acute hypopyon uveitis occurring in pat ients with AIDS to establish whether there was an association ol not. Methods All patients were referred by an infection desease specialty s ervice for complete ophthamological evaluation and ancillary laborator y. Six patients with AIDS, aged from 29 to 65 years, presented with ac ute unilateral hypopion.Results At the time of presentation, all six p atients were receiving treatment for MAC infection with Rifabutin (dos age range, 300-600 mg/d) and four received Fluconazol. Results of micr obiological investigations were negative. Hypopyon developed in the se cond eye of two patients. Hypopion resolved rapidely with intensive an tibiotherapy without corticosteroids. Conclusion Concomitant use of Ri fabutin and Fluconazol may precipitate hypopyon uveitis. The cause of the uveitis is less certain, but the possible role of a microbiologica l agent cannot be ruled out.