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Rare clinical presentation of genital tuberculosis in an adolescent girl
  1. Deepika Deepika and
  2. Lajya Devi Goyal
  1. Department of Obstetrics & Gynaecology, Aiims Bathinda, Bathinda, Punjab, India
  1. Correspondence to Dr Deepika Deepika, ROOM NO 1127 Deptt of Obstetrics &Gynaecology, Aiims Bathinda, Bathinda, Punjab, India; lhmcdeepika{at}gmail.com

Abstract

Genital tuberculosis, a form of extrapulmonary tuberculosis (EPTB), exhibits distinct presentations. In the outpatient department, an adolescent girl reported severe pain and a feeling of heaviness in her lower abdomen for the past 6–7 days. An enlarged pelvic mass, resembling a 20-week pregnancy, was observed, seemingly originating from the pelvis. During the local examination, a transverse septum was felt in the lower vagina, with a vaginal length of 2–3 cm. The ultrasound revealed distension of the vagina with fluid containing fine internal echoes, indicating haematocolpos. MRI showed the uterus pushed upward and located at the level of the umbilicus, suggesting hydrocolpos. Based on these findings, a provisional diagnosis of transvaginal septum with haematocolpos was made. Under anaesthesia, a cruciate incision was made over the vaginal septum, resulting in the drainage of 700–800 mL of pus. The drained fluid was sent for microscopic examination, gram staining, acid-fast bacilli smear culture, and Cartridge-based nucleic acid amplification test (CBNAAT). The CBNAAT test confirmed the presence of tubercle bacilli. Antitubercular therapy was initiated, and on completion of the treatment, the girl experienced the onset of menarche. This is a typical case with an unusual presentation of EPTB. What makes this case noteworthy is its initial manifestation as haematocolpos, a condition that shares a similar clinical presentation with Müllerian anomalies.

  • Reproductive medicine
  • Back pain

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Footnotes

  • Contributors DD was responsible for the drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision of important intellectual content. DD and LDG gave final approval to the manuscript. DD: drafting of the text, sourcing and editing of clinical images and surgery. LDG: surgery and design concept.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.