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Infectious Diseases in Obstetrics and Gynecology
Volume 2009, Article ID 745060, 4 pages
http://dx.doi.org/10.1155/2009/745060
Case Report

Genital Tuberculosis as the Cause of Tuboovarian Abscess in an Immunosuppressed Patient

Department of Obstetrics and Gynecology, Ludwig Maximilian University of Munich, Maistrasse 11, 80337 Munich, Germany

Received 17 April 2009; Revised 1 September 2009; Accepted 16 December 2009

Academic Editor: Ann Duerr

Copyright © 2009 M. Ilmer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Although tuberculosis (TB) is a major health problem worldwide, primary extrapulmonary tuberculosis (EPTB), and in particular female genital tract infection, remains a rare event. Case Report. A 35-year-old human immunodeficiency virus (HIV) seropositive woman of African descent with lower abdominal pain and fever of two days duration underwent surgery due to left adnexal mass suggesting pelvic inflammatory disease. The surgical situs showed a four quadrant peritonitis, consistent with the clinical symptoms of the patient, provoked by a tuboovarian abscess (TOA) on the left side. All routine diagnostic procedures failed to determine the causative organism/pathogen of the infection. Histopathological evaluation identified a necrotic granulomatous salpingitis and specific PCR analysis corroborated Mycobacterium tuberculosis (M. Tb). Consequently, antituberculotic therapy was provided. Conclusion. In the differential diagnosis of pelvic inflammatory disease, internal genital tuberculosis should be considered. Moreover, physicians should consider tuberculous infections early in the work-up of patients when immunosuppressive conditions are present.