Tuberculosis in the Female Genital Tract

Abstract

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.

The haunting diagnosis of malignancy in women with treatable reproductive system tuberculosis

“…In addition, the patient also presented with typical gastrointestinal symptoms such as early satiety, nausea, and vomiting, similar to what has been reported in other cases. 4,6 Our case mirrored others in presenting with ascites on ultrasound, as well as nonspecific abdominal distension, which is frequently seen in FG-TB cases. 9 The elevated levels of CA-125, a marker commonly associated with ovarian cancer, further complicated the diagnosis and initially led to a clinical diagnosis of ovarian cancer.…”

“…Similarly, pelvic pain, infertility, fever, unusual uterine hemorrhage, ascites, and pelvic mass have been reported in patients with FG-TB. [3][4][5][6] A tumor marker for ovarian cancer (cancer antigen-125 [CA-125]) may also rise in TB patients, although a pelvic mass with ascites, elevated CA-125 levels, and peritoneal seeding strongly suggest pelvic cancers.…”

“…3 Clinically, FG-TB presents with vague symptoms of abdominal pain, dyspareunia, abnormal genital tract bleeding, offensive vaginal discharge, menstrual irregularity, menorrhagia, and dysmenorrhea. 4 In some patients, FG-TB can be asymptomatic, while in others it may present with anorexia, episodes of diarrhea and vomiting, weight loss, night sweats, or intermittent fever. Similarly, pelvic pain, infertility, fever, unusual uterine hemorrhage, ascites, and pelvic mass have been reported in patients with FG-TB.…”

Tuberculosis in Regional Australia: Ectopic Pregnancy Complicating Indolent Genital Tract Disease

“…In men, it often produces a painless scrotal mass. In women, it may present as changes to menstruation or abnormal vaginal discharge [3,4] but more often remains hidden, diagnosed by serendipity as part of the investigations for infertility [5].…”

Case Report: Case report: Effect of intraovarian platelet-rich plasma therapy on latent female genital tuberculosis patient

“…FGTB is a type of extrapulmonary tuberculosis that has been seeing an increase in trend in young females globally, especially in developing countries. 3 As per the global tuberculosis report, it has been estimated that around 25% of the world's populace suffers from latent TB, which means they're asymptomatic despite exposure to the TB pathogen Mycobacterium tuberculosis. 3 Endometrial development has reportedly been affected due to the manifestation of TB, which is known to increase harmful cytokines in the decidual layer of the uterus.…”