García-López SJ, Pérez-Martínez A, Chávez-Martínez S, Sereno-Coló JA

Language: Spanish
References: 10
Page: 261-267
PDF size: 581.80 Kb.

ABSTRACT

Tuberculosis continues to be a worldwide public health issue, known as “the great pretender” resembling many diseases. Overall 1% of women infected with Mycobacterium species develop genital tuberculosis (GT) which is widespread more commonly during their fertility age, 20 -40 years old. GT is the second most common cause of extra pulmonary tuberculosis. One of the clinical manifestations in these patients is Infertility; with a poor prognosis of a successful pregnancy even with a correct diagnosis, medical and/or surgical treatment. Most pregnancies result in ectopic pregnancies or abortions. In low income countries GT may account for 5- 20% of infertility cases. It was widely believed that pregnancy represented a period of risk to women infected with tuberculosis; and actually abortion is suggested. We report a case of a 21 year old female patient who came to the General Hospital Dr. Miguel Silva in the city of Morelia, Michoacán with the diagnosis of late puerperium postpartum complicated with retained placental tissue to perform a uterine curettage. The patient had fever and anemia for which we had to perform a laparotomy exploration of the doubt of uterin perforation; the surgical findings were pathognomonic of GT for which we continue to realize Hysterectomy. The macro and microscopically pathologic findings consists in GT, confirming the diagnosis with Ziehl-Neelsen acid stain. GT findings must always be differentiated from ovarian cancer.

REFERENCES

1. Flores-Álvarez E, Tello-Brand SE, López-López F, Rivera- Barragán V. Tuberculosis peritoneal. Informe de siete casos. Cir Ciruj 2010;78:67-71.

2. S.N. Tripathy and S.N. Tripathy. Gynaecological tuberculosis . An update. Ind J Tub 1998;45:193.

3. Wen-Jai Guo, Guahn-Ren Shieh, Shih-Lung Chen. Female extrapulmonary genital tuberculosis: full-term deliveries after 4 years of follow-up. Taiwan J Obstet Gynecol 2010;49:105-108.

4. Sindhu N. Tripathy, Satchida N. Tripathy. Infertility and pregnancy outcome in female genital tuberculosis. International Journal of Gynecology & Obstetrics 2002;76:159-163.

5. AbdelAziem A. Ali, Tajeldin M. Abdallah. Clinical presentation and epidemiology of female genital tuberculosis in eastern Sudan. International Journal of Gynecology and Obstetrics 2012;118:236-238.

6. Figueroa-Damián R, Arredondo-García JL. Neonatal outcome of children born to women with tuberculosis. Arch Med Res 2001;32:66-9.

7. Hamadeh MA, Glassroth J. Tuberculosis and pregnancy. Chest 1992;101:1114-20.

8. Kim A. Boggess, MD, Evan R. Myers, MD, MPH, and Carol Dukes Hamilton, MD Antepartum or Postpartum Isoniazid Treatment of Latent Tuberculosis Infection. Obstet Gynecol 2000;96:757-762.

9. González Martínez ML, Navarro Gómez MM, Santos Sebastián J, Saavedra Lozano T. Tuberculosis en gestante y tuberculosis congénita. An Pediatr (Barc) 2009;70:512-4

10. Martin Llewelyn, Ian Cropley, Robert J Wilkinson, Robert N Davidson. Tuberculosis diagnosed during pregnancy: a prospective study from London. Thorax 2000;55:129-132.