Tuberculous pelvic inflammatory disease

Tuberculous pelvic inflammatory disease refers to pelvic inflammatory disease due to Mycobacterium tuberculosis.

Genital tract involvement may be present in ~1.5% of cases of those affected with tuberculosis 4.

Infection almost always results from spread from an extragenital source 1, usually haematogenous or less commonly via lymphatic vessels or from the peritoneal cavity.

Distribution

In the vast majority of cases, it involves the Fallopian tubes - tubal tuberculosis 1, and the involvement is often bilateral 4.

Hysterosalpingography (HSG)
  • tubal involvement:
    • obstruction of the Fallopian tube in the zone of transition between the isthmus and the ampulla
    • multiple constrictions (giving a beaded appearance) along the course of the Fallopian tube
  • endometrial involvement: features may vary; the spectrum according to one study was 2
    • normal uterine cavity:  ~57% 
    • irregular cavity: ~18.5%
    • irregular filling defect: ~18.5%
    • uterine synechiae:  ~17%
    • shrunken cavity: ~ 3%
  • adnexal involvement
    • may be calcified lymph nodes or smaller, irregular calcifications in the adnexal area
Complications

On hysterosalpingography consider:

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Article Information

rID: 13859
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Genital tuberculosis
  • Genital TB
  • Tuberculous PID
  • PID with TB

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Cases and Figures

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    Case 1: irrgular cavity with beaded tubes
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