Tuberculosis of the cervix: An uncommon cause of vaginal discharge in a post-menopausal woman

Kumari, Rajesh; Vaishya, Vandana; Khanna, Gaurav; Chauhan, Mukul; Sharma, Jai Bhagwan; Kriplani, Alka

doi:10.4103/0970-258x.255757

Cited by 6 publications

(8 citation statements)

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“…Ovarian cancer can develop due to peritoneal adhesions, nodules, and ascites, which are seen in abdominopelvic TB [ 11 ]. Likewise, cervical TB may mimic the cervical malignancy presented by symptoms like discharge from the vagina that is not normal [ 12 ]. GUTB is usually observed after the development of primary pulmonary TB or extrapulmonary lesion, for example, kidneys, meningeal area, skeletal system, and GI system through four routes: blood (in this, the pulmonary area will be the primary focus), direct spread, outspread through lymph nodes, and in rare cases, the reproductive tract through sexual transmission [ 13 ].…”

Section: Reviewmentioning

confidence: 99%

Tuberculosis in the Female Genital Tract

Kesharwani¹,

Mohammad²,

Pathak³

2022

Cureus

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Genitourinary tuberculosis (GUTB) is caused by Mycobacteria tuberculosis bacilli and is typically secondary to tuberculosis (TB) of the lungs. The spread largely occurs through the haematogenous route. Mycobacterium tuberculosis complex infections frequently cause the symptoms by reactivation of previously dormant tuberculous bacilli. Particularly in underdeveloped nations, female genital TB (FGTB) continues to be a key contributor to tubal blockage and infertility. It damages genital organs, which results in abnormal menstruation and infertility. FGTB is a chronic condition that manifests as mild symptoms. Almost all cases of genital TB include the fallopian tubes, which, together with endometrial involvement, render patients infertile. There may be asymptomatic cases. In order to save women from invasive surgery, it is vital to keep in mind the extremely rare but critical role of FGTB in the differential diagnosis of any malignancy. A thorough physical examination, careful history collection, and careful use of tests are done to arrive at a diagnosis. Hysterosalpingography has been recognised as the most accurate method for detecting FGTB and as the gold standard screening test for determining tubal infertility. Recently, there have been numerous improvements and modifications to FGTB management. The primary treatment for TB is a multidrug anti-TB regimen, while surgery may be necessary in more severe cases. Even after receiving multimodal therapy for TB, infertile women with genital TB have low conception rates and a significant risk of complications like ectopic pregnancy and loss.

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Section: Reviewmentioning

confidence: 99%

Tuberculosis in the Female Genital Tract

Kesharwani¹,

Mohammad²,

Pathak³

2022

Cureus

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“…Abdomino-pelvic TB may cause peritoneal adhesions, nodules and ascites and may simulate ovarian cancer [ 30 ]. Similarly, cervical TB may mimic cervical cancer causing abnormal vaginal discharge or vulval and vaginal ulcer or cancer [ 31 ].…”

Section: Epidemiologymentioning

confidence: 99%

Recent Advances in Diagnosis and Management of Female Genital Tuberculosis

Sharma

et al. 2021

J Obstet Gynecol India

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Female genital tuberculosis (FGTB) is an important cause of significant morbidity and infertility. Gold-standard diagnosis by demonstration of acid fast bacilli on microscopy or culture or detection of epithelioid granuloma on histopathology of endometrial or peritoneal biopsy is positive in only small percentage of cases due to its paucibacillary nature. Use of gene Xpert on endometrial or peritoneal biopsy has improved sensitivity of diagnosis. Composite reference standard (CRS) is a significant landmark in its diagnosis in which combination of factors like AFB on microscopy or culture, positive gene Xpert, epithelioid granuloma on endometrial or peritoneal biopsy, demonstration of definite or probable findings of FGTB on laparoscopy or hysteroscopy. There have been many advances and changes in management of FGTB recently. The program is now called National Tuberculosis Elimination Program (NTEP), and categorization of TB has been stopped. Now, patients are divided into drug-sensitive FGTB for which rifampicin (R), isoniazid (H), pyrazinamide (Z) and ethambutol (E) are given orally daily for 2 months followed by three drugs (rifampicin, isoniazid and ethambutol (RHE) orally daily for next 4 months. Multi-drug-resistant FGTB is treated with shorter MDR TB regimen of 9–11 months or longer MDR TB regimen of 18–20 months with reserved drugs. In vitro fertilization and embryo transfer have good results for blocked tubes and receptive endometrium, while surrogacy or adoption is advised for severe grades of Asherman’s syndrome.

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“…Latent TB, therefore, comprises of a diverse range of states, or a spectrum: All these states can lead to permanent disfigurement of the genital tract, and loss of fertility (Table 1). 2,12,14,20,[22][23][24][25] TB of the cervix is uncommon and may present as a growth or an erosion Table 2). 2,[12][13][14]20,22,[26][27][28] However, it is pertinent to state that these lesions may not always indicate active disease.…”

Section: Latent or Dormant Female Genital Tuberculosismentioning

confidence: 99%

“…25 These patients can be offered surgical correction in the form of transurethral resection of ejaculatory duct (Table 2). 2,[12][13][14]20,22,[26][27][28] Most patients with tubercular infertility require assisted reproduction, IFV, or intra-cytoplasmic sperm injection 53,54 as multiple organ involvement with obstruction at several sites is characteristic of genital TB and renders the case inoperable. 10,54 Testicular sperm extraction may be carried out if no sperm are obtained from the epididymis.…”

Section: Anatomical Changes and Clinical Presentationmentioning

confidence: 99%