Genital tuberculosis: Comparative study of the diagnostic modalities

Area of Science:

• Reproductive Medicine
• Infectious Diseases
• Microbiology

Background:

• Genital tuberculosis (GTB) is a significant cause of infertility.
• Clinical diagnosis of GTB is difficult due to asymptomatic presentation and varied symptoms.
• Routine laboratory tests have limited diagnostic value for GTB.

Purpose of the Study:

• To compare the diagnostic efficacy of polymerase chain reaction (PCR), acid-fast bacilli (AFB) culture, and AFB staining for genital tuberculosis.
• To evaluate the sensitivity and reliability of different diagnostic modalities for GTB.

Main Methods:

• Endometrial tissue samples from 227 women suspected of GTB were analyzed.
• Standard procedures for AFB staining, AFB culture, and PCR were employed.
• Comparison of results obtained from microscopy, culture, and PCR.

Main Results:

• Out of 227 samples, 133 were positive by at least one method.
• PCR detected 126 cases (86%) as positive, significantly more than microscopy and culture.
• PCR failed to detect 7 cases positive by culture, indicating potential false negatives.

Conclusions:

• PCR demonstrates higher sensitivity for GTB detection compared to conventional microscopy and culture.
• PCR facilitates earlier diagnosis of genital tuberculosis.
• The study recommends using both PCR and culture methods for reliable GTB diagnosis due to limitations of each individual method, including potential false positives/negatives with PCR.