[Clinical picture of genital tuberculosis in different forms of its pathogen]

Improvement of bacteriological diagnosis is of great value for the clinical picture of genital tuberculosis. The purpose of the study is to reveal the clinical features of genital tuberculosis in L-forms of Mycobacterium tuberculosis (MBT) versus traditional bacteriological methods and polymerase chain reaction (PCR) test with MBT DNA. A hundred and fourteen patients with verified active genital tuberculosis were examined. They were divided into 3 groups: 1) 36 patients with L-forms of MBT in the endometrial scrapes; 2) 32 with bacteriologically verified GT; 3) 46 with positive PCR test. A control group (Group 4) comprised 120 patients with NGD. Among the patients with L-forms there were prevalent females aged 21-40 years (83.4%). These patients had a history of spontaneous abortions more frequently than patients from other groups, in a third was found to have MBT with their L-variants. Signs of intoxication were observed in 47.2%. Oviductal obliteration and specific changes typical of tuberculosis were revealed on a hysterogram in 63.9%, other forms of prior and current extragenital tuberculosis were detected in a half of cases, traces of prior pulmonary tuberculosis were observed in 15%, 63.9% of the patients with L-forms and in 87% of those with positive PCR test were found to have pathological changes in the endometrium, which is indirectly indicative of its lesion. Thus, detection of L-forms of MBT in the endometrial scrapes leads to the conclusion that this is an active sluggish hematogenic tuberculous process, which is evidenced by a complex clinical and laboratory study.