Prosthetic joint infection by cat scratch

and the eye is treated with topical steroids. 3,4The condition is well reported in patients whose M. avium complex infection is HIV-associated, but immunocompetent individuals have also been affected. 5There seems to be a dose effect, with higher incidence and earlier onset with 600 mg than with 300 mg-cumulative risk at seven months 48% and 13%.With rifabutin withdrawal, uveitis lasted 4 days; with rifabutin continuation it persisted for nearly seven weeks.Low body weight increased the risk. 6he mechanism of rifabutin-associated uveitis is unknown.Some workers have proposed a Jarisch-Herxheimer-like reaction due to release of toxins by lysed bacteria.Against this hypothesis is the fact that, in M. avium infection, uveitis develops long after sterilization has been achieved whereas Herxheimer reactions occur soon after the start of treatment.Also, uveitis is not a side-effect of other drugs (such as clarithromycin) active against this infection.In the two published studies on Crohn's disease treated with rifabutin, 1,2 the incidence of uveitis was 4/46 and 1/7.Gastroenterologists and others using rifabutin for this purpose need to be aware of this side-effect and warn the patient.