Diagnosis and treatment of tuberculosis presenting as uveitis based on stochastic simulation in systems biology

ABSTRACT

Tuberculous uveitis can be a manifestation of extrapulmonary tuberculosis or an allergic reaction to tuberculosis infection. The clinical signs and symptoms of other uveitis causes are generic, making a false diagnosis simple. We present a brief introduction to theoretical modelling and simulation in systems biology and explore the consequences of TB uveitis if left untreated. Patients were admitted to our hospital with recurrent fever. They had a previous definitive diagnosis of binocular uveitis and a positive interferon gamma release assay (IGRA) test result. At the time, there was no antituberculosis medicine available, and immunosuppressive and glucocorticoid therapy did not work. After the admission, their pleural fluid tested positive for Mycobacterium tuberculosis. No other causes to explain the fever were found. A diagnosis of tuberculosis was made, and their body temperature normalized after antituberculosis treatment and closed chest drainage. Vigilance should be exercised to rule out tuberculous uveitis in cases of unexplained uveitis; this calls for IGRA screening, tuberculin skin testing, and cyst imaging. For patients with latent tuberculosis infections, it is recommended to administer antituberculosis treatment, after excluding other possible causes, and to avoid using glucocorticoids in isolation.

KEYWORDS:

• Tuberculosis, tuberculous uveitis
• extrapulmonary tuberculosis
• immune response
• antituberculosis treatment
• glucocorticoid

Availability of data and materials

The datasets used analysed during the current study are available from the corresponding author on reasonable request.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02648725.2023.2205197.

Additional information

Funding

The work was funded by the National Major Science and Technology Projects of China, Infectious Diseases Special Project, (Grant No.2018ZX10302302-004-006) and GuiZhou Provincial Basic Research Program, (Grant No. GuiZhou -ZK［2022］673). The role of the funding body is support the publication fee for us and a partial remission fees for clinical specimen detection

Notes on contributors

Li Liu

Li Liu is currently working as a physician at Affiliated Hospital of Zunyi Medical University Guizhou, China. She is also a graduate student pursuing her master degrees in Zunyi Medical University. Her research interests are lung infections and tuberculosis.

Yue Gou

Yue Gou is presently working as an ophthalmologist at Affiliated Hospital of Zunyi Medical University Guizhou, China. His project focuses on the vitreoretinal diseases, fundus fluorescein angiography, retinal fundus images and diagnosis of ophthalmic diseases.

Ling Chen

Ling Chen is currently working as Scientist and Specialist Physician at Affiliated Hospital of Zunyi Medical University Guizhou, China. Her main research interests include lung infections, latent infection with Mycobacterium tuberculosis and pulmonary tuberculosis. And she has got a number of publications in reputed international/national journals.

Zhaojing Zong

Zhaojing Zong is currently working as a Specialist Physician at Affiliated Hospital of Zunyi Medical University Guizhou, China. Her current research interest focuses on fungal pulmonary infections, tuberculosis, and pharmacokinetics of antituberculosis drugs.