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GENITAL TUBERCULOSIS

TB is an infectious disease caused by mycobacterium tuberculosis. Genital tuberculosis follows pulmonary tuberculosis. Pulmonary tuberculosis spread from lungs to other body parts through blood as bacteria get accumulated in the genital tract it cause genital tuberculosis. Spread of infection from the vagina, cervix and the vulva may occur. Genital tuberculosis is common cause of infertility in male and female.

Causes

• Mycobacterium tuberculosis, mycobacterium bovis is the main agent.
• Lack of health care facilities
• Kidney disease
• Drug use
• May result from direct inoculation during intercourse with person having genital tuberculosis.
• Haematogenous spread.

Symptoms

• Infertility
• Abdominal pain
• Menstrual abnormalities
• Excessive vaginal discharge
• Chronic pelvic inflammation
• General symptoms : pyrexia, anorexia

Diagnosis

• Nucleic acid amplification test
• Immunological test
• Biopsy
• Body fluid examination
• HSG ( hysterosalpingography)
• Endoscopy: laparoscopy, hysteroscopy.

Treatment

• Drug treatment

          For initial two months

                   Isoniazid, Rifampicin    Ethambutol, Pyrazinamide

          Second line drug for intensive phase

              Kanamycin, Ofloxacin, Ethionamide, Cycloserine

• Surgical treatment

Generally surgical treatment is avoided. Limited surgical treatment like drainage of large residual pelvic/ tubo – ovarian abscess,