Screening for genital tuberculosis in a limited resource country: case report.
Screening for benign or malignant process of pelvis in young females is a challenge for a physician in a limited resource country. Tuberculosis should be always considered in the differential diagnosis of a pelvic mass in countries with high prevalence of tuberculosis. Negative results of analysis of peritoneal fluid for acid-fast staining, late cultures, and unavailability of new diagnostics methods such as polymerase chain reaction and adenosine deaminase of the aspirated fluid from peritoneal cavity can often result in invasive diagnostic procedures such as laparotomy.



We report a case of a 24 year old Albanian unemployed female living in urban place in Kosovo who presented with abdominal pain, loss of appetite, fever, headache, a weight loss, nonproductive cough and menstrual irregularity for three weeks. In this example case, the patient with cystic mass in tubo-ovarial complex and elevated serum cancer antigen 125 levels was diagnosed for genital tuberculosis after performing laparotomy. Caseose mass found in left tubo-ovarial complex and histopathological examination of biopsied tissue were the fastest diagnostic tools for confirming pelvis TB. The Lowenstein-Jensen cultures were positive after six weeks and her family history was positive for tuberculosis.



Young females with abdominopelvic mass, ascites, a positive family history for tuberculosis and high serum cancer antigen 125, should always raise suspicion of tuberculosis especially in a limited resource country. A laparoscopy combined with peritoneal biopsy should be performed to confirm the diagnosis as this could lead to a prevention of unnecessary laparotomies.
Clinic of Infectious Diseases, University Clinical Center of Kosovo, Prishtinë, Kosovo. sadie_namani@yahoo.com.|Medical Faculty, University of Prishtina, Kongresi i Manastirit 3A, Prishtinë, Kosovo. sadie_namani@yahoo.com.
Sadie
0000-0002-2411-8623
S
Namani
Clinic of Infectious Diseases, University Clinical Center of Kosovo, Prishtinë, Kosovo.
Emine
E
Qehaja-Buçaj
Smart Center, Prishtinë, Kosovo.
Diellëza
D
Namani
D000005:Abdomen / Q000000981:diagnostic imaging; D015746:Abdominal Pain; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001201:Ascites / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D001706:Biopsy; D018394:CA-125 Antigen / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010535:Laparoscopy; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009852:Omentum / Q000382:microbiology / Q000473:pathology; D019152:Paracentesis; D010537:Peritoneum / Q000382:microbiology / Q000473:pathology; D014384:Tuberculosis, Female Genital / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014463:Ultrasonography
D000995:Antitubercular Agents; D018394:CA-125 Antigen
CA-125; Developing countries; Genital tuberculosis; Kosovo