[Rifabutin-induced hypopyon iritis in HIV infection].

BACKGROUND

Rifabutin is a new semisynthetic rifamycin which is approved in Germany for clinical application since 1/15/95. The drug is used for prophylaxis and treatment of Mycobacterium avium intracellulare (MAI) infection in patients with AIDS. In 1994 it was reported that rifabutin can cause anterior uveitis. This side effect is dose-dependent and aggravated, when the drug is combined with clarithromycin and/or fluconazol.

PATIENT

A 32-year-old woman suffered from acquired immunodeficiency syndrome and systemic MAI. She was treated with a combination of rifabutin (450 mg/day), clarithromycin (750 mg/day) and ethambutol (800 mg/day). 78 days later she developed a unilateral hypopyon iritis.

RESULTS

Rifabutin was discontinued and topical steroids and mydriatics were given. The uveitis disappeared within two weeks.

CONCLUSIONS

The ophthalmologist should be aware of this new potential etiology of anterior uveitis. Rifabutin should be withdrawn immediately. Anti-inflammatory eye drops might be helpful.