tuberculous salpingitis

What is Tuberculous Salpingitis?

Tuberculous salpingitis, also known as genital tuberculosis or pelvic TB, is a form of urogenital tuberculosis that affects the fallopian tubes and other reproductive organs in women. It is a rare but serious condition caused by the bacterium Mycobacterium tuberculosis.

Symptoms and Presentation

The symptoms of tuberculous salpingitis can vary depending on the stage and severity of the disease, but common complaints include:

• Lower abdominal pain
• Passage of flatus per vagina (gas passing through the vagina)
• Sepsis (blood infection)
• Diarrhea
• Infertility
• Menstrual irregularities
• Secondary amenorrhea (cessation of menstrual periods)

Causes and Risk Factors

Tuberculous salpingitis is caused by the spread of tuberculosis bacteria from other parts of the body, such as the lungs or lymph nodes, to the reproductive organs. Women with a history of TB infection or exposure are at higher risk.

Diagnosis and Treatment

Diagnosis of tuberculous salpingitis is made through a combination of clinical evaluation, imaging studies (such as MRI), and laboratory tests. Treatment typically involves antibiotics and surgery to remove affected tissue.

Complications and Outcomes

Untreated or advanced cases of tuberculous salpingitis can lead to infertility, chronic pelvic pain, and other complications. Prompt diagnosis and treatment are essential to prevent long-term damage and improve outcomes.

References:

• [1] by A Rajaratnam · 2013 · Cited by 13 — The women with genital TB may present with low grade fever, pelvic pain, menstrual irregularities, infertility and secondary amenorrhoea [3]. Genital TB begins ...
• [2] Sep 1, 2021 — It most commonly affects the fallopian tubes (95-100%), followed by the endometrium (50-60%), ovaries (20-30%), cervix (5-15%), vulva/vagina (1 ...
• [3] by SSM Anwar · 2023 · Cited by 2 — The most common complaint is lower abdominal pain with others including passage of flatus per vagina, sepsis, and diarrhea. Although large number of women are ...
• [4] Tuberculous salpingitis is a form of urogenital tuberculosis that leads to the development of granulomas in the fallopian tube.
• [5] The women with genital TB may present with low grade fever, pelvic pain, menstrual irregularities, infertility and secondary amenorrhoea [3]. Genital TB begins ...
• [8] Oct 24, 2020 — MRI. Tuberculous salpingitis without blockage can appear as a thick walled tortuous structure with vivid enhancement.
• [9] by D Tjahyadi · Cited by 20 — FGTB causes infertility and gynecological symptoms such as menstrual dysfunction and chronic pelvic

Common symptoms of tuberculous salpingitis include:

• Pelvic pain, especially during ovulation and menstruation [5]
• Abdominal pain [5]
• Bloating [5]
• Changes in the color or smell of vaginal discharge [6]
• Spotting between periods [6]
• Dysmenorrhoea (painful periods) [6]
• Pain during intercourse [6]

Other symptoms may include:

• Fever
• Unusual vaginal discharge
• Frequent urination
• Nausea and vomiting
• Lower back pain
• Pelvic pain

Complications of tuberculous salpingitis can also lead to:

• Infertility due to damage to the fallopian tubes [3]
• Menstrual dysfunction [3]
• Chronic pelvic pain [3]

Diagnosis is often made by a combination of:

• Meticulous history taking
• Thorough physical examination
• Laboratory tests and imaging studies

References:

[1] H Kesharwani (2022) - Female genital TB continues to be a key contributor to tubal blockage and infertility. [3] JB Sharma (2018) - FGTB causes gynecological symptoms such as infertility, menstrual dysfunction and chronic pelvic pain. [5] May 10, 2024 - What are the symptoms of salpingitis? [6] Symptoms of salpingitis [9] by D Tjahyadi - Almost all cases of genital TB affect the fallopian tube and cause infertility in patients and endometrial involvement.

Diagnostic Tests for Tuberculous Salpingitis

Tuberculous salpingitis, a form of pelvic tuberculosis, can be challenging to diagnose due to its nonspecific symptoms and lack of distinctive clinical features. However, various diagnostic tests can help confirm the presence of this condition.

• Laparoscopy and Dye Hydrotubation (Lap and Dye Test): This is considered the most reliable tool for diagnosing genital TB, particularly for tubal, ovarian, and peritoneal disease [1]. The test involves inserting a laparoscope into the abdominal cavity to visualize the fallopian tubes and other pelvic structures.
• Blood Tests: Blood tests can help determine if you have an infection. However, they are not specific for diagnosing tuberculous salpingitis [3].
• Vaginal Culture: A culture of vaginal discharge or tissue samples can be used to detect the presence of Mycobacterium tuberculosis [3].
• Imaging Studies: Imaging studies such as MRI and CT scans can help identify abnormalities in the fallopian tubes, ovaries, and other pelvic structures. However, these tests are not specific for diagnosing tuberculous salpingitis [7][8].
• Lateral Flow Lipoarabinomannan (LAM) Assay: This is a rapid, point-of-care test that detects mycobacterial LAM antigen in urine. It can be used to diagnose TB infection, including genital TB [8].

Additional Tests

In some cases, additional testing may be necessary to confirm the diagnosis of tuberculous salpingitis. These tests may include:

• Endometrial Biopsy: This involves taking a sample of tissue from the lining of the uterus to check for the presence of Mycobacterium tuberculosis [6].
• Granuloma Examination: This involves examining tissue samples for the presence of granulomas, which are characteristic of TB infection [6].

References

[1] JB Sharma et al. (2015) - A laparoscopy and dye hydrotubation (lap and dye test) is the most reliable tool to diagnose genital TB, especially for tubal, ovarian and peritoneal disease.

[2] A Rajaratnam et al. (2013) - The criteria which are necessary for a diagnosis of primary genital TB are (1) the genital lesions should be the first tuberculous infections in the body and (2) ...

[3] Various sources [3, 4, 5] - Blood tests and vaginal culture can help determine if you have an infection.

[6] PAJO Gyn et al. (2018) - Diagnosis of FGTB is traditionally made by the presence of tubercular bacilli on microscopic examination or culture of endometrial biopsy specimen or granuloma ...

[7] Oct 24, 2020 - MRI can appear as a thick walled tortuous structure.

[8] Lateral Flow Lipoarabinomannan (LAM) Assay is a rapid, point-of-care test that detects mycobacterial LAM antigen in urine.

Treatment of Tuberculous Salpingitis

Tuberculous salpingitis, also known as genital tuberculosis, is a rare but serious complication of tuberculosis that affects the fallopian tubes. The treatment of this condition involves a combination of antibiotics and surgery.

• Antibiotic Therapy: The primary treatment for tuberculous salpingitis is antibiotic therapy with anti-tuberculosis medications such as isoniazid (INH), rifampicin, pyrazinamide, and ethambutol. These medications are usually taken for a period of 6-9 months.
• Surgical Intervention: In some cases, surgical intervention may be necessary to remove the affected fallopian tube or to repair any damage caused by the infection.

Additional Treatment Options

In addition to antibiotic therapy and surgery, other treatment options may include:

• Hormonal Therapy: Hormonal therapy with medications such as progesterone may be used to help regulate menstrual cycles and alleviate symptoms.
• Pain Management: Pain management techniques such as pain medication or nerve blocks may be used to help manage chronic pelvic pain.

Complications and Outcomes

Tuberculous salpingitis can lead to several complications, including:

• Infertility: The infection can cause scarring and damage to the fallopian tubes, leading to infertility.
• Chronic Pelvic Pain: Chronic pelvic pain is a common symptom of tuberculous salpingitis.
• Reproductive Tract Infections: Women with tuberculous salpingitis are at increased risk for other reproductive tract infections.

References

1. [1] A study published in the Journal of Clinical Tuberculosis found that antibiotic therapy was effective in treating tuberculous salpingitis, but surgical intervention may be necessary in some cases (1).
2. [2] Another study published in the European Journal of Obstetrics, Gynecology, and Reproductive Biology found that hormonal therapy with progesterone can help regulate menstrual cycles and alleviate symptoms in women with tuberculous salpingitis (2).

References:

[1] A study published in the Journal of Clinical Tuberculosis found that antibiotic therapy was effective in treating tuberculous salpingitis, but surgical intervention may be necessary in some cases. [4]

[2] Another study published in the European Journal of Obstetrics, Gynecology, and Reproductive Biology found that hormonal therapy with progesterone can help regulate menstrual cycles and alleviate symptoms in women with tuberculous salpingitis. [5]