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“TB - Mindedness”-the only way to beat “the great mimicker”: A case series with atypical presentation of female genital tuberculosis

Indian journal of tuberculosis, 2024-04, Vol.71 (2), p.179-184 [Peer Reviewed Journal]

2023 Tuberculosis Association of India ;Copyright © 2023 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved. ;ISSN: 0019-5707 ;DOI: 10.1016/j.ijtb.2023.04.027 ;PMID: 38589122

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  • Title:
    “TB - Mindedness”-the only way to beat “the great mimicker”: A case series with atypical presentation of female genital tuberculosis
  • Author: Saha, Ashmita ; Singh, Nilanchali ; kashyap, Deepika ; Kulshrestha, Anshul ; Sarkar, Avir ; Sharma, Jai B. ; Roy, Kallol Kumar
  • Subjects: Atypical presentation of female genital tuberculosis ; Female ; FGTB ; Genital tuberculosis ; Humans ; Infertility, Female - etiology ; Prospective Studies ; Tuberculosis - complications ; Tuberculosis, Female Genital - drug therapy ; Tuberculosis, Urogenital - complications
  • Is Part Of: Indian journal of tuberculosis, 2024-04, Vol.71 (2), p.179-184
  • Description: Incidence of Tuberculosis (TB) cases in India reported in 2019 is 193 per 1 lakh population [National Tuberculosis Elimination Plan (NTEP)]. In India, annual extra pulmonary TB burden is 20–25%, of which 4% of cases are of urogenital origin (Revised National TB Control Programme, 2019; World Health Organization, 2019). The Ministry of Health and Family Welfare has made a target of eliminating tuberculosis by 2025 under the NTEP by the process of identification, notification and treatment of cases. Tuberculosis being a leading cause of infertility in developing countries, employing best clinical practices and being “TB-minded” will also save the patient of enormous anxiety and uncertainity and also decrease the time gap between clinical presentation and diagnosis to optimize fertility outcome. A prospective cohort study of cases presenting with unusual findings and ultimately being diagnosed as genital tuberculosis was conducted in the gynaecology OPD, AIIMS, New Delhi, from November 2020 to November 2021 (1 year). Patients were investigated judiciously, diagnosis made and followed up for their response to anti tuberculosis therapy (ATT). This data comprises of conglomerate of ten cases with unconventional exhibition of genital tuberculosis. 70% of the cases presented with pain lower abdomen not specifically related to menstrual cycle and often confused with IBD. Tubo ovarian mass (70%) mimicking as simple ovarian cyst, ovarian carcinoma or endometriosis was the most common clinical finding we came across. •The objective of our study is to elaborate the diagnostic challenges faced and provide the follow up profile of patients on ATT for FGTB.•The purpose of doing this study was to point out that after decades of research on tuberculosis, we still get mislead by the clinical presentation and there is substantial delay in starting ATT, compromising the standard of care.•Chronic Pain abdomen, often non-specific in nature should ring the alarm about abdominal/pelvic tuberculosis.•Pelvi-abdominal mass with raised CA-125 is not always ovarian carcinoma.•Empirically starting ATT without any histopathological and microbiological confirmation, based on symptoms and relevant investigations seems to be an important and correct clinical decision in most of the cases.
  • Publisher: India: Elsevier B.V
  • Language: English
  • Identifier: ISSN: 0019-5707
    DOI: 10.1016/j.ijtb.2023.04.027
    PMID: 38589122
  • Source: GFMER Free Medical Journals
    MEDLINE
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