
Deepika
, INDIATitle: Rare presentation of Genital tuberculosis in young female as Primary amenorrhea with pyocolpos
Abstract
Introduction:
Genital tuberculosis is the most
mysterious form of Extrapulmonary tuberculosis represents 15-20% of EPTB. The
spread is generally through haematogenous or lymphatic routes.
Case Report:
14 year old female presented with severe
pain in lower abdomen in outpatient
department of our hospital .Pain was insidious in onset and aggravated one week
back . History revealed she had primary amenorrhea .There is no history
of fever, weight loss, night sweats of loss of appetite, weight loss
bowel and bladder complaints. In family, father had history of pulmonary
Tuberculosis. On examination general condition fair , thin built with BMI
16kg/m2. ,breast examination with
axillary and pubic hair were Tanner stage 3 .Abdomen was soft and there
was no distension. A pelvic mass of 20 weeks size midline cystic with restricted mobility was
present in pelvis. Vulval inspection revealed . Per vaginum -thick hymenal ring
present .Per rectal examination revealed
bulging of posterior vaginal wall into the rectum. USG showed vagina
appears distended with fluid containing fine internal echoes collection
measuring 15.8x8.8x10.6 cm approximately. Uterus is pushed up and is seen lying
at the level of umbilicus and bilateral adnexa and ovaries are normal. Fluid
containing fine echoes is seen distending vaginal cavity s/o hydrocolpos.
Routine investigations were normal limits. The girl was planned for drainage in
view of ? Imperforate hymen with hydrocolpos .Under anaesthesia when a small
incision was given over the intact hymen. About 700ml -800 ml pus drained out.
It was sent for gram staining, AFB smear-culture and CBNAAT. Foleys catheter was placed in vagina. Soframycin
applied locally . Z-N stain of the pus showed plenty of Acid Fast Bacilli.
CBNAAT showed tubercle bacilli. Antitubercular therapy with intensive
phase 4-drugs started and follow-up is
continuing.This case is unique and
interesting because the age of presentation makes and the clinical picture was such that one
will be tempted to diagnose as hematocolpos leading to primary amenorrhea.
Biography
Dr Deepika
working as Assistant professor in department of obstetrics and gynaecology
AIIMS Bathinda India.She has over 12 publications in national and international
journals. She is Associate member of Royal college of Obstetrics and Gynaecology
.She is member of reputed societies AICOG, AOGD and MNAMS.