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Latent pelvic tuberculosis reactivating in a postmenopausal woman: a case report
Howard B Goldstein1, Robert P Siefring
1Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School at Camden/Cooper University Hospital, Camden, New Jersey, USA. howieg91@aol.com
Background:
Tuberculosis most often affects the pulmonary system; however, 8-15% of cases infect the genitourinary system. The primary treatment of uterine tuberculosis is medical therapy, and only when that fails is surgical intervention warranted.
Case:
A 75-year-old woman presented with chronic back pain and fatigue. She had been on prednisone for 9 years for autoimmune hepatitis and had earlier exposure to tuberculosis. Evaluation led to the diagnosis of uterine tuberculosis. The patient was unable to tolerate a full course of antituberculin therapy, so she underwent an abdominal hysterectomy and bilateral salpingo-oophorectomy.
Conclusion:
We believe the patient had latent uterine tuberculosis that was reactivated from her chronic steroid use. If she had a purified protein derivative test prior to the start of prednisone therapy, latent tuberculosis may have been diagnosed and treated before she developed a clinically active infection.
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