Latent pelvic tuberculosis reactivating in a postmenopausal woman: a case report.
BACKGROUND
Tuberculosis most often affects the pulmonary system; however, 8-15% of cases infect the genitourinary system. The primary treatment of uterine tuberculosis is medical therapy, and only when that fails is surgical intervention warranted.


METHODS
A 75-year-old woman presented with chronic back pain and fatigue. She had been on prednisone for 9 years for autoimmune hepatitis and had earlier exposure to tuberculosis. Evaluation led to the diagnosis of uterine tuberculosis. The patient was unable to tolerate a full course of antituberculin therapy, so she underwent an abdominal hysterectomy and bilateral salpingo-oophorectomy.


CONCLUSIONS
We believe the patient had latent uterine tuberculosis that was reactivated from her chronic steroid use. If she had a purified protein derivative test prior to the start of prednisone therapy, latent tuberculosis may have been diagnosed and treated before she developed a clinically active infection.
Goldstein
Howard B
HB
Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School at Camden/Cooper University Hospital, Camden, New Jersey, USA. howieg91@aol.com
Siefring
Robert P
RP
D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D019693:Hepatitis, Autoimmune / Q000150:complications; D006801:Humans; D007044:Hysterectomy; D007538:Isoniazid / Q000627:therapeutic use; D010052:Ovariectomy; D012008:Recurrence; D012293:Rifampin / Q000627:therapeutic use; D014384:Tuberculosis, Female Genital / Q000150:complications / Q000175:diagnosis* / Q000628:therapy
D000995:Antitubercular Agents; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin