Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2023; 11(14): 3248-3255
Published online May 16, 2023. doi: 10.12998/wjcc.v11.i14.3248
Diagnosis of tuberculous uveitis by the macrogenome of intraocular fluid: A case report and review of the literature
Yan-Kun Zhang, Yan Guan, Juan Zhao, Li-Fei Wang
Yan-Kun Zhang, Yan Guan, Department of Ophthalmology, Hebei Chest Hospital, Shijiazhuang 050047, Hebei Province, China
Juan Zhao, Department of Respiratory, Hebei Chest Hospital, Shijiazhuang 050047, Hebei Province, China
Li-Fei Wang, Department of Ophthalmology, Hebei Eye Hospital, Xingtai 050010, Hebei Province, China
Author contributions: Zhang YK contributed to design and drafting the manuscript; Guan Y, Zhao J and Wang LF contributed to case collection; and all authors approved the final version of the manuscript.
Supported by the Medical Science Research Project of Hebei Province, No. 20191029.
Informed consent statement: The patient signed an informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Fei Wang, Chief Physician, Doctor, Department of Ophthalmology, Hebei Eye Hospital, No. 399 Quanbei East Street, Xingtai 050010, Hebei Province, China. 928246030@qq.com
Received: September 3, 2022
Peer-review started: September 3, 2022
First decision: February 14, 2023
Revised: February 28, 2023
Accepted: March 24, 2023
Article in press: March 24, 2023
Published online: May 16, 2023
Processing time: 174 Days and 3 Hours
Abstract
BACKGROUND

Tuberculous uveitis caused by tuberculosis infection factors is common, but tuberculous uveitis caused by Mycobacterium tuberculosis found in the intraocular fluid is rare. This report describes the use of intraocular fluid in the diagnosis of tuberculous uveitis in a patient and reviews the relevant literature.

CASE SUMMARY

A 24-year-old woman who was 31-wk pregnant visited Hebei Chest Hospital due to intermittent chest pain, fever, and decreased vision for 3 mo. The hydrothorax test suggested “tuberculous pleurisy”, and yellow effusion was extracted from the chest tube twice resulting in a total volume of approximately 800 mL. The patient chose to continue the pregnancy without treatment, and was hospitalized again due to high fever. Following 2 mo of anti-tuberculosis treatment, a healthy boy was delivered by cesarean section. Tuberculous uveitis was diagnosed using tuberculosis Xpert, and intraocular infection was detected by second-generation gene sequencing. Following systemic treatment, the patient gradually improved, and the corrected visual acuity of the left eye gradually increased from 0.08 to 1.0.

CONCLUSION

The etiology of uveitis is complex, and it is necessary to assess the patient’s general condition and apply molecular biology methods to determine the pathogenesis and guide precise treatment, to improve clinicians’ awareness and standardize treatment of the disease.

Keywords: Tuberculous uveitis, Metagenomic next-generation sequencing, Xpert, Case report

Core Tip: Tuberculous uveitis caused by tuberculosis infection factors is common, but tuberculous uveitis caused by Mycobacterium tuberculosis found in intraocular fluid is rare. This report describes a 24-year-old pregnant patient who was diagnosed using tuberculosis Xpert and ophthalmologic multimodal imaging after 2 mo of anti-tuberculosis treatment and cesarean delivery of a healthy baby boy. Detection of intraocular infections can be performed by second-generation genetics. Folowing systemic treatment, the patient’s vision recovered.