Thus, these methods have poor sensitivity and specificity for the diagnosis of FGTB throughout the sub-clinical stages. According to tissue reactions, in those having tuberculosis may at times be atypical and bacteriologically mute. Sampled sites may not represent the infected area and the infected site can be simply missed due to sparse number of paucibacillary nature of mycobacteria. Ĭonventional/phenotypic methods have slow and low detection rates and have limitations due to secondary nature of genital tuberculosis. Use of menstrual blood for bacteriologic or molecular diagnosis has been recommended but was reported to show low sensitivity. Since, there is no way to take the fallopian tubes out, sampling from the ovaries and endometrium was suggested for the detection of FGTB. Usually, it is a rare condition, following haematogenous spread and causing infertility. Further the conditions like, oophoritis (inflammation of the ovaries) are also often seen in combination with salpingitis (inflammation of the fallopian tubes). In such cases, the granulomatous endometrium may not show evidence of tuberculosis in all the cycles.
Results of endo biopsy serial#
Studies on serial sections of tissues are needed because the lesions are frequently erratic and even in that case also positive endometrial culture for TB was found only in 25% of cases of tuberculous endometritis as the endometrium is often focal and moreover, due to the cyclical shedding of the endometrium, granulomas do not have enough time to form.
Results of endo biopsy skin#
A positive chest X-ray for healed or active pulmonary tuberculosis, contact history, elevated erythrocyte sedimentation rate (ESR), positive tuberculin skin test and sampling by laparoscopy may specify the need for further investigations –. Therefore, a high degree of suspicion assisted by intensive investigation is significant in the diagnosis of the disease. Though, the actual incidence may be under-reported due to asymptomatic, varied clinical presentations, diverse imaging, transforming laparoscopic results and a mixed bag of bacteriological and serological tests. Thangappah et al revealed that 57% of infertile women in whom the presence of TB was suspected on clinical grounds had a positive endo-TB-PCR test, whereas only 9.5% had a positive test with no clinical ground for suspicion. It is estimated that at least 11% of the patients lack symptoms and FGTB is often detected in diagnostic workup of women attending infertility clinics. It generates worrying effects, causing irreversible damage to the fallopian tube with potential consequences of causing infertility and making it untreatable both by medical and surgical methods. tuberculosis (MTB) is a facultative intracellular acid-fast gram-positive pathogenic bacterium capable of producing both a progressive disease and an asymptomatic latent infection. Compared with culturing and Ziehl-Neelsen's staining, multi-gene PCR demonstrated improvement in the detection of FGTB (χ 2 = 214.612, 1 df, McNemar's test value <0.0001). The specificity of multi-gene PCR was 100%. Multi-gene PCR was found to have much higher sensitivity of 70.29% with MTB64 gene, 86.63% with 19 kDa antigen gene at species and TRC4 element at regional MTB complex and 88.12% with 32 kDa protein gene at genus level. The conventional methods showed 99% to 100% specificity with a low sensitivity, ranging from 21.78% to 42.08% while hematoxylin and eosin staining showed a sensitivity of 51.48%. All women of control group were confirmed as negative for tuberculosis. The presence of MTB DNA was observed in 49.5% of ETBs, 33.17% of OTBs and 5.44% of PAF specimens collected from highly suspected FGTB patients. All specimens were tested by conventional techniques, later compared with multi-gene PCR for the detection of Mycobacterium tuberculosis (MTB) and correlated with laparoscopic findings. A total of 302 specimens were collected both from 202 infertile women highly suspected of having FGTB on laparoscopy examination and 100 control women of reproductive age.
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