Diagnosis of tuberculous uveitis by the macrogenome of intraocular fluid: A case report and review of the literature

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.