title: A case of panuveitis with hypopyon due to presumed ocular leishmaniasis in a HIV patient.
abstract: BACKGROUND
  Post-kala-azar dermal leishmaniasis is a well-known immunologic cutaneous reaction. There are few case reports of ocular leishmaniasis. It is a sight-threatening condition that needs to be rapidly recognized and treated to avoid permanent visual loss. Ocular leishmaniasis panuveitis can present with severe inflammation in patients with highly active anti-retroviral therapy (HAART)-induced immune reconstitution syndrome.
  
  
  RESULTS
  A case of a 40-year-old man, human immunodeficiency virus (HIV) positive on HAART, with a presumed diagnosis of ocular leishmaniasis, is presented. He had a past history of visceral leishmaniasis and was referred to the uveitis service with rapidly worsening panuveitis and counting fingers vision in both eyes. On empirical anti-leishmania therapy and systemic steroids, the visual acuity of the left eye improved to 6/9 but remained poor in the right eye. Based on the medical history, improvement with therapy and the exclusion of other common infections, a presumed diagnosis of ocular leishmaniasis-related panuveitis was made.
  
  
  CONCLUSIONS
  A major immune reaction against lingering parasites may play a key role in the pathogenesis of this sight-threatening and rapidly progressive condition. Both the infection and the immune reaction should be treated.
authors.affiliation: Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK. Simon.couture@moorfields.nhs.uk.|Département d'Ophtalmologie et ORL-Chirurgie cervico-faciale, Université Laval, Québec, G1TW4, Canada. Simon.couture@moorfields.nhs.uk.
authors.forename: Simon
authors.initials: S
authors.lastname: Couture
authors.affiliation: Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK. Rupesh_agrawal@ttsh.com.sg.|National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, 308433, Singapore. Rupesh_agrawal@ttsh.com.sg.
authors.forename: Rupesh
authors.initials: R
authors.lastname: Agrawal
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK. kate.woods2@nhs.net.
authors.forename: Kate
authors.initials: K
authors.lastname: Woods
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK. Diana.lockwood@lshtm.ac.uk.
authors.forename: Diana
authors.initials: D
authors.lastname: Lockwood
authors.affiliation: Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK. carlos.pavesio@moorfields.nhs.uk.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Pavesio
authors.affiliation: Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK. peter.addison@moorfields.nhs.uk.
authors.forename: Peter K F
authors.initials: PK
authors.lastname: Addison
keywords: Granulomatous panuveitis; HIV; Immune reconstitution uveitis; Ocular leishmaniasis