title: Genital tuberculosis in a tamoxifen-treated postmenopausal woman with breast cancer and bloody vaginal discharge.
abstract: BACKGROUND
  Female genital tuberculosis is an uncommon disease that is rarely diagnosed in developed countries.
  
  
  METHODS
  A 61-year-old postmenopausal woman who had undergone surgery and treated with adjuvant chemotherapy for infiltrating ductal carcinoma of the breast five years ago, presented with bloody vaginal discharge, fatigue, weight loss, and low grade fevers at night for two months. Histological examination of the endometrium, done based on the suspicion of a second primary cancer due to the tamoxifen therapy, revealed a granulomatous reaction. Liquid and solid mycobacterial cultures of the tissues were performed. Although the acid fast staining was negative, the liquid culture was positive for Mycobacterium tuberculosis. Involvement of other systems was not detected. The patient was treated with a three-drug antituberculosis regimen for 9 months and recovered fully.
  
  
  CONCLUSIONS
  Female genital tuberculosis is a rare but curable disease that should be included in the differential diagnosis of women with menstrual problems. Early diagnosis is important and may prevent unnecessary invasive procedures for the patient.
authors.affiliation: Laboratory of Mycobacteriology, Department of Clinical Bacteriology, Parasitology, Zoonoses, and Geographical Medicine, University Hospital of Heraklion, 712 01 Heraklion, Crete, Greece. neos@med.uoc.gr
authors.forename: Ioannis
authors.initials: I
authors.lastname: Neonakis
authors.forename: Elpis
authors.initials: E
authors.lastname: Mantadakis
authors.forename: Zoe
authors.initials: Z
authors.lastname: Gitti
authors.forename: Ioanna
authors.initials: I
authors.lastname: Mitrouska
authors.forename: Louis George
authors.initials: LG
authors.lastname: Manidakis
authors.forename: Sofia
authors.initials: S
authors.lastname: Maraki
authors.forename: George
authors.initials: G
authors.lastname: Samonis
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D013629:Tamoxifen / Q000009:adverse effects*; D016896:Treatment Outcome; D014384:Tuberculosis, Female Genital / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D000900:Anti-Bacterial Agents; D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen