Genital tuberculosis as the cause of tuboovarian abscess in an immunosuppressed patient.
BACKGROUND
Although tuberculosis (TB) is a major health problem worldwide, primary extrapulmonary tuberculosis (EPTB), and in particular female genital tract infection, remains a rare event.


METHODS
A 35-year-old human immunodeficiency virus (HIV) seropositive woman of African descent with lower abdominal pain and fever of two days duration underwent surgery due to left adnexal mass suggesting pelvic inflammatory disease. The surgical situs showed a four quadrant peritonitis, consistent with the clinical symptoms of the patient, provoked by a tuboovarian abscess (TOA) on the left side. All routine diagnostic procedures failed to determine the causative organism/pathogen of the infection. Histopathological evaluation identified a necrotic granulomatous salpingitis and specific PCR analysis corroborated Mycobacterium tuberculosis (M. Tb). Consequently, antituberculotic therapy was provided.


CONCLUSIONS
In the differential diagnosis of pelvic inflammatory disease, internal genital tuberculosis should be considered. Moreover, physicians should consider tuberculous infections early in the work-up of patients when immunosuppressive conditions are present.
Department of Obstetrics and Gynecology, Ludwig Maximilian University of Munich, Maistrasse 11, 80337 Munich, Germany.
M
M
Ilmer
F
F
Bergauer
K
K
Friese
I
I
Mylonas
D018784:Abdominal Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D005184:Fallopian Tube Diseases / Q000000981:diagnostic imaging / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D006651:Histocytochemistry; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification; D010049:Ovarian Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology; D016133:Polymerase Chain Reaction; D014384:Tuberculosis, Female Genital / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000276:immunology; D014463:Ultrasonography
D000904:Antibiotics, Antitubercular