Tuberculous pelvic inflammatory disease

Last revised by Dr Matt A. Morgan on 24 Oct 2020

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 from a hematogenous source or less commonly, via lymphatic vessels or from the peritoneal cavity.

In the vast majority of cases, it involves the Fallopian tubes: tubal tuberculosis 1, Involvement is often bilateral 4.

  • tubal involvement:
    • obstruction of the Fallopian tube in the zone of transition between the isthmus and the ampulla
    • multiple constrictions along the course of the Fallopian tube (resulting in a beaded appearance to the 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
    • they may be calcified lymph nodes or smaller, irregular calcifications in the adnexal area

Tuberculous pelvic inflammatory disease may be associated with

For the hysterosalpingography appearance consider:

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Cases and figures

  • Case 1: irregular cavity with beaded tubes
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  • Case 2: tubal involvement in genital tuberculosis
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