Dr.Samyak Mulkutkar, Dr.Manogya Jain

Abstract

HIV+ 47 Y/F had LE sudden painful loss of vision for 1 day.Vision CF, fibrin in AC, hypopyon & no view of fundus.USG-localised vitritis & attached retina. RE WNL.Systemically asymptomatic, no history of oral/genital ulcers, joint pains, fever, urinary issues, IV drugs/trauma.She responded to steroid drops & atropine.Detailed imaging, blood culture, rheumatologist/pulmonologist opinion was all negative.CD4 & CD4:CD8 ratio were low.CMV & Rubella Ig-G were positive, but CMV viral load was low & without any positive clinical correlation.As inflammation improved, fundus was normal with spillover vitritis. Next week, RE also had hypopyon uveitis & responded to same drops.She had no other clinical & systemic features.
Retrospectively, she was found to be receiving Rifabutin 300mg/day for 1 month as part of AKT for TB lymphadenitis.
Rifabutin was identified as possible culprit & replaced after consulting pulmonologist.
Ocular inflammation resolved & vision restored after stopping rifabutin.