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[一名患有生殖器结核的摩洛哥女性]

[A Moroccan woman with genital tuberculosis].

作者信息

Vellekoop J, Roumen F J M E

机构信息

Atrium Medisch Centrum Parkstad, afd. Obstetrie en Gynaecologie, Postbus 4446, 6401 CX Heerlen.

出版信息

Ned Tijdschr Geneeskd. 2008 Mar 15;152(11):627-31.

Abstract

A 28-year-old nulliparous Moroccan woman presented at an outpatient gynaecology clinic because she had been unable to conceive for the last 2 years. She had an enlarged right adnexus. Histopathological examination of the resected right adnexus was suspicious for tuberculosis. After isolating Mycobacterium bovis from a psoas abscess 3 months later, a 6-month regimen with anti-tuberculosis drugs was started, and the clinical response was good. Female genital tuberculosis is rare in developed countries. Symptoms are few and non-specific. The disease can be suspected incidentally during the subfertility work-up. The fallopian tubes are the most commonly affected site. A definitive diagnosis is difficult to make, even when tuberculosis is strongly suspected. Histopathological findings can support a diagnosis of tuberculosis, and molecular PCR techniques that detect DNA are promising. Treatment of genital tuberculosis is similar to that of pulmonary tuberculosis, although it is difficult to monitor treatment response. The chance of spontaneous conception after treatment is very small, and IVF is often the only treatment option.

摘要

一名28岁未生育的摩洛哥女性因过去两年未能受孕,前往妇科门诊就诊。她右侧附件肿大。切除的右侧附件的组织病理学检查怀疑为结核病。3个月后从腰大肌脓肿中分离出牛分枝杆菌,开始了为期6个月的抗结核药物治疗,临床反应良好。女性生殖器结核在发达国家很少见。症状少且无特异性。该病可能在不孕症检查过程中偶然被怀疑。输卵管是最常受累的部位。即使强烈怀疑为结核病,也很难做出明确诊断。组织病理学检查结果可支持结核病诊断,检测DNA的分子PCR技术很有前景。生殖器结核的治疗与肺结核相似,尽管很难监测治疗反应。治疗后自然受孕的机会非常小,体外受精往往是唯一的治疗选择。

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