Ramon P M, Tillie-Leblond I, Labalette P, Wallaert B, Tonnel A B
Service de Pneumologie et Immuno-allergologie, Hôpital Albert-Calmette, Lille.
Rev Mal Respir. 1998 Apr;15(2):204-6.
Rifabutin is an effective drug in the treatment of Mycobacterium avium complex (MAC). Rare adverse effects have been described in non immunocompromised patients. We report the case of a 35 year-old woman, negative for the human immunodeficiency virus (HIV), who had an isolated pulmonary infection caused by MAC. Under Rifabutin (600 mg/day), Clarithromycin and Ethambutol, an uveitis, associated with a pseudojaundice and polyarthralgia, appeared, while pulmonary infection improved. Improvement of adverse effects was obtained with non-steroid anti-inflammatory drugs, local steroid treatment for uveitis and lower doses of Rifabutin (300 mg/day). Those adverse effects have not been previously described with this dose of Rifabutin in a non HIV patient. The mechanism remained unknown. The decrease of Rifabutin doses associated with symptomatic treatments allow the preservation of an effective treatment for MAC infection.