OVERVIEW
Overview.
Tuberculous Pelvic Inflammatory Disease (TPID) is an inflammatory disease of the female genitals caused by Mycobacterium tuberculosis, also known as pelvic tuberculosis and genital tuberculosis. This disease is mainly secondary to tuberculosis in other parts of the patient’s body, and is prevalent in young and middle-aged women between 20 and 40 years old. The main manifestations are infertility, menstrual abnormalities, lower abdominal pain and fever.
Whether medical insurance
Yes
Department
Gynecology
Alias: Pelvic tuberculosis, genital tuberculosis
Pelvic tuberculosis, genital tuberculosis.
Clinical symptoms
Infertility, menstrual abnormalities, lower abdominal pain, fever, etc.
Harm
May lead to infertility.
Examination
Blood sedimentation, X-ray, endometrial pathology, uterine tubal iodine oil angiography, etc.
Diagnosis
Diagnosis is based on the manifestations of infertility, menstrual abnormalities, lower abdominal pain, fever, etc., combined with X-ray film and endometrial pathology examination.
Treatment principle
Anti-tuberculosis drug treatment and surgical treatment.
Curable
Symptoms can be improved by active treatment.
Dietary advice
Give high protein and high vitamin diet, avoid greasy and stimulating food.
Etiology
Epidemiology
The disease is prevalent in young adult females between the ages of 20 and 40.
Etiology
Caused by the invasion of tubercle bacilli into the reproductive organs.
Transmission
Bloodstream transmission, intra-abdominal spread, lymphatic transmission, sexual contact.
Symptoms and Diagnosis
Typical symptoms
1. Infertility: women suffering from tuberculosis of the reproductive organs basically have primary or secondary infertility, mainly due to infertility, and the correct diagnosis is made only after examination by a doctor.
2. Abnormal menstruation: menorrhagia and amenorrhea are common.
3. Lower abdominal pain: the pain may be mild or severe, and the abdominal pain may be accompanied by fever in tuberculosis infection.
4. Fever: hot flashes in the afternoon or during menstruation, or prolonged low-grade fever.
Diagnostic basis
1. Medical history
Family history of tuberculosis contact or history of tuberculosis, such as pulmonary tuberculosis, urinary tract tuberculosis and renal tuberculosis.
2. Clinical manifestations
(1) Symptoms: infertility, abnormal menstruation, lower abdominal pain, fever, etc.
(2) Signs: genital tuberculosis can be found in the abdomen with pressure pain, tenderness or signs of ascites, and may be coexisted with peritoneal tuberculosis; simple mild internal genital tuberculosis may have no positive signs in the abdomen. The uterus may be normal in size and mobility, but it may also be hypoplastic or less mobile due to the presence of adhesions. The fallopian tubes are thickened bilaterally and become hard like cords. In severe cases, lumps of different sizes may form in the adnexa, which are fixed and painful to touch.
3.Auxiliary examination
(1) Laboratory tests: accelerated blood sedimentation, although not specific, but if there is a suspicion of chronic mild internal genital tuberculosis, accelerated blood sedimentation often indicates that the lesion is still active.
(2) X-ray: attention should be paid to the presence of old tuberculous foci or signs of pleural tuberculosis.
(3) Pathologic examination: taking endometrium for pathologic examination is a reliable and commonly used method to diagnose reproductive tuberculosis.
(4) Pelvic X-ray and uterine tubal iodine-oil contrast: as Mycobacterium tuberculosis can cause different damage to the fallopian tubes, ovaries,
endometrium and muscular layer of the uterus, including caseous necrosis, ulcer formation and eventual scarring or calcification, pelvic X-ray or uterine and fallopian tube oil iodine angiography can be used to help make a clear diagnosis.
(5) Laparoscopy.
Treatment
Treatment guidelines
Anti-tuberculosis medication and surgery.
Drug therapy
Anti-tuberculosis drug therapy is the effective method for treating tuberculous pelvic inflammation, and the commonly used drugs are rifampicin, isoniazid, ethambutol, pyrazinamide, streptomycin, kanamycin and so on.
Surgical treatment
When the tubal ovary has formed a mass, long-term symptoms, drugs can not be cured or have been given a sufficient amount of drugs but the effect is unsatisfactory, still recurring, according to the patient’s age and the scope of the lesion, discretionary surgical resection can be given.
Other treatments
Strengthen nutrition, ensure sufficient sleep, and bed rest for patients with active lesions.
Prognosis
Early and timely treatment has a better prognosis.
Nursing care
Daily care
1. Pay attention to personal hygiene to avoid infection.
2. Chronic patients can engage in some light work and study, but pay attention to the combination of work and rest.
3. Ensure enough sleep and keep a good mindset.
Diet regulation
Give high protein and high vitamin diet, avoid greasy and stimulating food.