Trimethoprim-associated uveitis and retinal vasculitis

Uveitis secondary to sulfonamides is a well-documented adverse effect. The frequent co-administration of sulfonamides with trimethoprim potentially under-recognises trimethoprim as a cause of medication-induced uveitis. We present a case of bilateral uveitis and retinal vasculitis associated with trimethoprim monotherapy. Written consent was obtained from the patient. Ethics approval for this study was obtained from the Human Research Ethics Committee (HREC) of the South Australian Health Institute. The tenets of the Declaration of Helsinki of 1975 were adhered to.

A 74-year-old female presented with 4 weeks of bilateral, painless, blurred vision. She reported cobwebs affecting first her right then both eyes. Past ocular history was significant for left squint surgery in childhood and bilateral cataract extraction 9 months prior with uncomplicated recovery. She had commenced trimethoprim for dysuria 1 week prior to visual decline. A urine microscopy culture and sensitivity was performed at the time which demonstrated growth of Escherichia coli. She took perindopril and pravastatin for hypertension and hypercholesterolaemia. She had no known allergies...