Ghosh K, Ghosh K, Chowdhury J R
National Institute of Immunohaematology, 13th Flr., KEM Hospital, Mumbai, India.
J Postgrad Med. 2011 Oct-Dec;57(4):307-13. doi: 10.4103/0022-3859.90082.
Tuberculosis (TB) is an important cause of mortality and morbidity all over the world and is particularly relevant in developing countries like India where the disease is endemic. Female reproductive system is very vulnerable to this infection and clinical presentation of this disease in female reproductive tract is protean in nature and in a large majority of patients could be completely silent. This disease is an important cause of infertility, menstrual irregularity, pregnancy loss, and in association with pregnancy, morbidity to both the mother and child increases. Some of the effects of TB infection on female genital tract could be remote in nature due to infection elsewhere. Medicines used to treat TB infection can also have adverse effects on contraception and other areas of female reproductive health. HIV coinfection and multidrug-resistant tuberculosis (MDR-TB) and increased population migration from developed to developing countries have now added a whole new dimension to this infection. Though new, finer diagnostic tools of detection of TB are increasingly available in the form of bacterial cultures and polymerase chain reaction (PCR) based diagnostics, suspicion by clinicians remains the main tool for diagnosis of the condition. Hence, doctors need to be properly trained to become "Tuberculosis Minded".
结核病是全球死亡和发病的重要原因，在印度等疾病流行的发展中国家尤为突出。女性生殖系统极易受到这种感染，该疾病在女性生殖道中的临床表现具有多样性，大多数患者可能完全没有症状。这种疾病是不孕、月经不调、流产的重要原因，而且与妊娠相关时，母婴发病率都会增加。由于其他部位的感染，结核病感染对女性生殖道的一些影响可能是间接的。用于治疗结核病感染的药物也可能对避孕和女性生殖健康的其他方面产生不利影响。合并感染艾滋病毒和耐多药结核病（MDR-TB）以及从发达国家到发展中国家的人口迁移增加，现在给这种感染带来了全新的层面。尽管新型、更精细的结核病检测诊断工具，如细菌培养和基于聚合酶链反应（PCR）的诊断方法越来越多，但临床医生的怀疑仍然是诊断该病的主要手段。因此，医生需要接受适当培训，成为“具有结核病意识的人”。
