Zhang Yan-Kun, Guan Yan, Zhao Juan, Wang Li-Fei
Department of Ophthalmology, Hebei Chest Hospital, Shijiazhuang 050047, Hebei Province, China.
Department of Respiratory, Hebei Chest Hospital, Shijiazhuang 050047, Hebei Province, China.
World J Clin Cases. 2023 May 16;11(14):3248-3255. doi: 10.12998/wjcc.v11.i14.3248.
Tuberculous uveitis caused by tuberculosis infection factors is common, but tuberculous uveitis caused by 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.
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.
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.
由结核感染因素引起的结核性葡萄膜炎较为常见，但在眼内液中发现的结核性葡萄膜炎却很罕见。本报告描述了在一名患者中使用眼内液诊断结核性葡萄膜炎的情况并回顾相关文献。
一名24岁、孕31周的女性因间歇性胸痛、发热及视力下降3个月就诊于河北省胸科医院。胸腔积液检查提示“结核性胸膜炎”，两次经胸腔引流管引出黄色胸水，总量约800 mL。患者选择未治疗继续妊娠，后因高热再次住院。抗结核治疗2个月后，行剖宫产娩出一健康男婴。采用结核Xpert诊断结核性葡萄膜炎，并通过二代基因测序检测到眼内感染。经全身治疗后，患者逐渐好转，左眼矫正视力从0.08逐渐提高至1.0。
葡萄膜炎病因复杂，需评估患者全身情况并应用分子生物学方法确定发病机制，指导精准治疗，以提高临床医生对该病的认识并规范治疗。
