Abstract

BackgroundPelvic tuberculosis is a rare form of extrapulmonary tuberculosis. It commonly involves the fallopian tubes and the uterus from a lympho-hematogeneous spread. The presentation of pelvic tuberculosis as an isolated ovarian abscess is extremely rare and is reported only twice.Case presentationa 25 yrs. old para III mother in the post partum period undergone laparotomy for suspected tuboovarian abscess/ovarian tumor after presenting with abdominal pain, pelvic mass and fever. Intra-operatively, Isolated right ovarian mass with caseation in the cavity but no significant pelvic adhesions was detected and right oophorectomy was done. Post operative Histopathology of surgical specimens revealed tuberculous leision and patient recovered well after anti-tuberculosis treatment.ConclusionIsolated ovarian tuberculosis is a very rare form of Genital Tuberculosis which should always be considered in the evaluation of a woman presenting with any adnexal mass in highly prevalent areas.

Highlights

  • Tuberculosis (TB) is one of the top 10 causes of death worldwide

  • It is estimated that Genital Tb affects about 12% of women with pulmonary Tuberculosis (PTB) and 15 to 20% of women with EPTB [3]

  • Case presentation A 25 years old, married, para III, Ethiopian Somali woman presented with an insidious onset of lower abdominal pain, offensive vaginal discharge and intermittent fever of 1 month duration

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Summary

Introduction

Tuberculosis (TB) is one of the top 10 causes of death worldwide. There were 1.4 million TB deaths and estimated 10.4 million new TB cases in 2015 [1]. Case presentation A 25 years old, married, para III, Ethiopian Somali woman presented with an insidious onset of lower abdominal pain, offensive vaginal discharge and intermittent fever of 1 month duration. She had associated anorexia, vomiting & episodic diarrhoea which were followed by progressive weight loss and drenching night sweats. She lived with 2 relatives in the same room who were being treated for pulmonary tuberculosis 2 years ago All her previous pregnancies and deliveries were uneventful. Digital vaginal examination findings were: smooth & firm cervix; bulging pouch of Douglas; firm 18 cm by 18 cm sized pelvic right adnexal mass with adnexal and cervical motion tenderness. Culture and immune-histologic analysis were not done because of facility constraints The woman was put on anti-Tb regimen (category-I) containing INH, Rifampicin, Pyrazinamide and Ethambutol and showed dramatic improvement at her follow up visit after completing the intensive phase

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