Diagnosis of Genital Tuberculosis Unveiled by Utero-Cutaneous Fistula and Superimposed MRSA Infection: A Case Report

Both tuberculosis and Methicillin-Resistant Staphylococcus aureus (MRSA) are known to be notorious for causing fistulas due to their characteristics of persistent, difficult-to-treat infections that lead to chronic inflammation, abscess formation, and tissue necrosis. There are several case reports highlighting the invasiveness and potential for fistula formation associated with both tuberculosis and MRSA infections independently, but to the best of our knowledge, this is the first case of a utero-cutaneous fistula caused by chronic infection due to MRSA, superadded on genital tuberculosis.

A 35-year-old female, P3L3, visited the gynaecology outpatient department nine months after her last caesarean section with the complaint of severe pain and blood discharge from the transverse supra-pubic scar during menstruation. On evaluation, she was found to be chronically infected with MRSA and have genital tuberculosis only after histopathologic examination of the fistulous tract and tubo-ovarian abscess.

This case highlights the importance of considering genital tuberculosis in patients with atypical or refractory post-surgical complications and emphasizes the need for a thorough and multidisciplinary approach to its management.