Click on image for details. Tuberculosis TB is an important cause of mortality and morbidity all over the world and is particularly relevant in developing countries like India where the disease is endemic. Female reproductive system is very vulnerable to this infection and clinical presentation of this disease in female reproductive tract is protean in nature and in a large majority of patients could be completely silent. This disease is an important cause of infertility, menstrual irregularity, pregnancy loss, and in association with pregnancy, morbidity to both the mother and child increases. Some of the effects of TB infection on female genital tract could be remote in nature due to infection elsewhere. Medicines used to treat TB infection can also have adverse effects on contraception and other areas of female reproductive health. HIV coinfection and multidrug-resistant tuberculosis MDR-TB and increased population migration from developed to developing countries have now added a whole new dimension to this infection. Though new, finer diagnostic tools of detection of TB are increasingly available in the form of bacterial cultures and polymerase chain reaction PCR based diagnostics, suspicion by clinicians remains the main tool for diagnosis of the condition.
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Tuberculosis of the Female Genital Tract
The morbidity and mortality due to tuberculosis TB is high worldwide, and the burden of disease among women is significant, especially in developing countries. Mycobacterium tuberculosis bacilli reach the genital tract primarily by haematogenous spread and dissemination from foci outside the genitalia with lungs as the common primary focus. Genital TB in females is a chronic disease with low-grade symptoms. The fallopian tubes are affected in almost all cases of genital TB, and along with endometrial involvement, it causes infertility in patients. Many women present with atypical symptoms which mimic other gynaecological conditions.
Genital tuberculosis TB in females is by no means uncommon, particularly in communities where pulmonary or other forms of extragenital TB are common. TB can affect any organ in the body, can exist without any clinical manifestation, and can recur. TB was recognized as a clinical entity as far back as BC. However, it was not until that Morgagni, 1 following a postmortem examination of a year-old woman who died of TB and whose uterus and fallopian tubes were found to be filled with caseous material, described the first case of genital TB. The word tuberculosis was first used in , although Koch did not discover the tubercle bacilli until TB is considered the most important communicable disease in the world. Since the beginning of the 20th century, the incidence of TB in general and genital TB more particularly has been steadily declining in developed countries. However, TB remains a major health problem in many developing countries, and in these areas, genital TB is responsible for a significant proportion of females presenting with infertility. A review of the literature reveals that the highest incidence of TB is still in India, followed by Scandinavia and Scotland.
