Isolated ovarian tuberculosis in an Immuno- competent woman in the post partum period: case report

Abstract

BackgroundPelvic tuberculosis is a rare form of extrapulmonary tuberculosis. It commonly involves the fallopian tubes and the uterus from a lympho-hematogeneous spread. The presentation of pelvic tuberculosis as an isolated ovarian abscess is extremely rare and is reported only twice.Case presentationa 25 yrs. old para III mother in the post partum period undergone laparotomy for suspected tuboovarian abscess/ovarian tumor after presenting with abdominal pain, pelvic mass and fever. Intra-operatively, Isolated right ovarian mass with caseation in the cavity but no significant pelvic adhesions was detected and right oophorectomy was done. Post operative Histopathology of surgical specimens revealed tuberculous leision and patient recovered well after anti-tuberculosis treatment.ConclusionIsolated ovarian tuberculosis is a very rare form of Genital Tuberculosis which should always be considered in the evaluation of a woman presenting with any adnexal mass in highly prevalent areas.

Pelvic and central nervous system tuberculosis complicated by a paradoxical response manifesting as a spinal tuberculoma: a case report

“…This is a striking case of ETB with involvement of the CNS, abdominal cavity, and uterus presenting after miscarriage. Like similarly reported cases [9][10][11][12][13][14][15][16][17][18][19], it is likely that pregnancy increased the patient's risk of reactivation of latent TB. Given the late presentation in this case, it is unclear whether TB caused the miscarriage or how changes in physiology (e.g., immune reconstitution) after the miscarriage contributed to the presentation.…”

“…In addition, immune reconstitution in the post-partum period has been associated with unmasking or worsening symptoms of TB [9,10]. While reports of TB presenting in the postpartum period are well documented [9][10][11][12][13][14][15], few have described TB presenting after abortion [16][17][18][19].…”

Ovarian tuberculosis-A rare case report

“…7 Crohn's disease, endometriosis and history of prior surgery should be ruled out as one of the probable cause of ovarian granuloma. 6,7 Tuberculosis may present with many nonspecific symptoms which are also seen in other conditions such as malignancy. It is necessary to offer multiple investigations panel to patient to make definitive diagnosis.…”

“…Treatment modality for both tuberculosis and malignancy differs as tuberculosis may be treated by anti tubercular treatment while cases with malignancy may require extensive surgical procedures. 6…”

Ovarian Tuberculosis masquerading as malignancy - Case report of 2 cases with review of literature

“…[3] The proper diagnosis can be delayed due to absence of specific symptoms and conclusive signs during physical examination. [4] Preoperative investigations which may aid in diagnosis include staining the pleural and ascitic fluid with ZN stain and look for acid fast bacilli and a positive mantoux test and sometimes these tests can be negative in spite of extensive disease. [7] Tumor markers like CA-125 levels can be estimated.…”