Female Genital Tuberculosis: Report of 2 Unusual Cases

From May 2005 to September 2017, two patients with female genital tuberculosis (FGTB) were treated at Taipei Tzu Chi Hospital. FGTB was difficult to diagnose because of its protean clinical manifestations. One patient, a 55-year-old woman, experienced abdominal fullness, leg edema, and general weakness. Computed tomography revealed massive ascites, uterine masses, and right pleural effusion. The acid-fast stains for sputum and ascites yielded negative results. Under suspicion of ovarian malignancy, left salpingo-oophorectomy and endometrial curettage were performed, and frozen pathologic study revealed caseous granuloma. Antituberculosis (anti-TB) drugs were administered, and the patient's status improved. The other patient, an 81-year-old woman, presented with purulent vaginal discharge and bleeding. Dilation and curettage revealed endometrial TB. Anti-TB drugs were administered, but the patient died of other disease. For frail patients, anti-TB drugs may be harmful. The number of FGTB cases in our hospital may be underestimated. Of 12 patients with TB peritonitis, only 1 received FGTB diagnosis. Laparoscopy is useful for FGTB diagnosis in patients with TB peritonitis.