ch 8. Female Genital Tuberculosis

Posted: May 13, 2012 in Gynocology
  •  TB does not spread by touch or sharing of utensils. It spreads when someone with an active TB infection coughs, sneezes, or spits, and you come in contact with the bacteria released as a result. (Such bacteria usually remain suspended in air for a long time.) 
  •  If the bacteria enter the lungs of a woman, it may affect her genital organs over a period of time. The infection usually begins in the fallopian tubes and then spreads down to the uterus. 
Common primary focuses –
  1. Lungs (50%)
  2. Lymph nodes (40%)
  3. Urinary tract (5%)
  4. Bones and joints (5%)

Involvement of organs –

  1. Fallopian tubes – 100%
  2. Endometrium – 50%
  3. Ovaries – 20%
  4. Cervix – 5%
  5. Vagina and vulva – <1%
Mode of spread –
  1. Blood stream:most common
  2. Direct spread from peritoneum
  3. Sexually transmitted by infected partner
Differential  Diagnosis –
  1. Ovarian cyst
  2. Pelvic inflammatory disease
  3. Ectopic pregnancy
  4. Carcinoma cervix
  5. Elephantiasis vulva (Lymphatic Filariasis)
Tuberculosis of Fallopian Tubes :

This commonly begins in the Fallopian tubes. As the fimbriated extremities open into the peritoneum they absorb any such virus as that of tuberculosis which may be present. Hence it is a regular result of tubercular peritonitis in the female, and also sometimes occurs in tubercular ulceration of the intestine.

Tuberculosis of the Fallopian tubes begins at the distal end, and this part is generally found most affected. The mucous membrane is destroyed and replaced by caseous matter which accumulates in the calibre of the tube. The wall is also thickened and infiltrated with the tubercular new-formation. These two conditions lead to a great distension of the tube ,so as to resemble some of the conditions resulting from salpingitis. The condition is sometimes called Tubercular salpingitis.

Tubercular salpingitis

Tuberculosis of Fallopian tubes seen from behind a Uterus

Tuberculosis of Fallopian tubes seen from behind a Uterus

Tuberculosis of Uterus :
17 % of the women who have pulmonary (lung) TB develop uterine and pelvic TB over a period of time, if untreated or undetected.
Tuberculosis of Ovaries :
30% Cases involment. Infertility.
Tuberculosis of Cervix :
1-2% all cases
Tuberculosis of Vulva and Vagina :
Rarely hypertrophic form.
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