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坦桑尼亚达累斯萨拉姆一家私立医院的结核性子宫内膜炎罕见病例报告。

A rare case report of tuberculosis endometritis in a private hospital Dar es salaam, Tanzania.

作者信息

Kyejo Willbroad, Moshi Brenda, Gidion Daudi, Abeid Muzdalifat, Somji Samina, Kaguta Munawar, Mgonja Miriam

机构信息

Department of Family Medicine, Aga Khan University, Dar Es Salaam, Tanzania.

Department of Obstetrics and Gynecology, Aga Khan Hospital, Dar Es Salaam, Tanzania.

出版信息

SAGE Open Med Case Rep. 2023 Jan 17;11:2050313X221150054. doi: 10.1177/2050313X221150054. eCollection 2023.

Abstract

Tuberculosis endometritis is a pathological diagnosis and has been always over shadowed by pelvic tuberculosis. It is usually asymptomatic, but patients could complain of menstrual irregularity and per vaginal discharge. We report a case of a 37-year-old female who presented with per vaginal discharge for 2 years. Histopathology showed numerous caseating and non-caseating granulomas with plasma cells, Ziehl-Neelsen stain for acid fast bacillus is positive, and she was initiated on anti-tuberculosis treatment. On subsequent follow-up visits, patient was doing well with complete resolution of symptoms. Genital tuberculosis is usually caused by reactivation of organism from systemic distribution during primary infection. It is estimated that approximately 8 million cases of tuberculosis occur worldwide every year, 95% of which are from developing countries. Tuberculosis usually affects the lung but about one-third of patients have extra pulmonary involvement which include female genitals organs and other organs. Genital tuberculosis is an indolent infection: its common symptoms include pelvic pain, vaginal bleeding, amenorrhea, vaginal discharge, and infertility. Most of the patients respond quickly after initiating anti-tuberculosis medications. We recommend that all patients with a positive Ziehl-Neelsen stain and menstrual abnormalities undergo aggressive evaluation for genital tuberculosis.

摘要

结核性子宫内膜炎是一种病理诊断,一直以来都被盆腔结核所掩盖。它通常无症状,但患者可能会主诉月经不规律和阴道分泌物异常。我们报告一例37岁女性,她出现阴道分泌物异常2年。组织病理学显示有大量干酪样和非干酪样肉芽肿以及浆细胞,抗酸杆菌萋-尼染色呈阳性,遂开始对她进行抗结核治疗。在随后的随访中,患者病情好转,症状完全消失。生殖器结核通常是由原发感染期间全身播散的病原体重新激活所致。据估计,全球每年约有800万例结核病发生,其中95%来自发展中国家。结核病通常累及肺部,但约三分之一的患者有肺外受累,包括女性生殖器官和其他器官。生殖器结核是一种潜伏性感染:其常见症状包括盆腔疼痛、阴道出血、闭经、阴道分泌物异常和不孕。大多数患者在开始抗结核药物治疗后反应迅速。我们建议所有萋-尼染色阳性且有月经异常的患者都要积极评估是否患有生殖器结核。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec1e/9850118/0284920e8697/10.1177_2050313X221150054-fig1.jpg

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