title: Sepsis During Immunosuppression for Sight-threatening Uveitis: The Flip side.
abstract: OBJECTIVE
  To highlight the rare but life-threatening infective consequences of immunosuppression or biologic treatment for sight-threatening uveitis.
  
  
  METHODS
  Retrospective case series of four immunosuppressed patients with uveitis complicated by sepsis.
  
  
  RESULTS
  The affected patients were all treated using prednisolone 10 mg/day or greater, together with oral immunosuppression (2 mycophenolate mofetil, 1 azathioprine + ciclosporin, 1 methotrexate) and, in one case, infliximab. All patients survived following intensive treatment.
  
  
  CONCLUSIONS
  Life-threatening infection is a rare but important risk in immunosuppressed patients with uveitis. Complete protection is not possible and prophylaxis regimens are of unproven efficacy. Patients should understand the risks before agreeing to a course of treatment.
authors.affiliation: a Manchester Royal Eye Hospital , Central Manchester University Hospitals, NHS Foundation Trust, Manchester, UK; Medical Academic Health Science Centre, University of Manchester , Manchester , UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Jones
mesh_terms: D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use; D016470:Bacteremia / Q000209:etiology*; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007710:Klebsiella Infections / Q000209:etiology; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000627:therapeutic use; D016720:Pneumocystis Infections / Q000209:etiology; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies; D014605:Uveitis / Q000188:drug therapy*
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D009173:Mycophenolic Acid; D001379:Azathioprine; D008727:Methotrexate