Een vrouw uit Marokko met genitale tuberculose

- A 28-year-old nulliparous Moroccan woman presented at an outpatient gynaecology clinic because she had been unable to conceive for the last 2 years. She had an enlarged right adnexus. Histopathological examination of the resected right adnexus was suspicious for tuberculosis. After isolating Mycobacterium bovis from a psoas abscess 3 months later, a 6-month regimen with anti-tuberculosis drugs was started, and the clinical response was good. Female genital tuberculosis is rare in developed countries. Symptoms are few and non-specific. The disease can be suspected incidentally during the subfertility work-up. The fallopian tubes are the most commonly affected site. A definitive diagnosis is difficult to make, even when tuberculosis is strongly suspected. Histopathological findings can support a diagnosis of tuberculosis, and molecular PCR techniques that detect DNA are promising. Treatment of genital tuberculosis is similar to that of pulmonary tuberculosis, although it is difficult to monitor treatment response. The chance of spontaneous conception after treatment is very small, and IVF is often the only treatment option.

Ned Tijdschr Geneeskd. 2008;152:627-31