Overview
Tuberculous pelvic inflammatory disease (PID) is a form of pelvic inflammatory disease caused by Mycobacterium tuberculosis. It is a less common cause of PID compared to bacterial infections.Diagnosis
Diagnosis can be challenging due to nonspecific symptoms and the rarity of pelvic tuberculosis 1.
Diagnostic methods may include:
Microscopy and culture of menstrual fluid or endometrial biopsy for Mycobacterium tuberculosis* 1.
* Histopathological examination of endometrial biopsy 1.
* Tuberculin skin test (TST) or interferon-gamma release assay (IGRA) 1.
* Imaging studies such as ultrasound, CT, or MRI may suggest pelvic involvement but are not diagnostic 1.Management
Management involves a multi-drug anti-tuberculosis regimen, typically for at least six months 1.
Standard first-line anti-tuberculosis drugs include isoniazid, rifampicin, pyrazinamide, and ethambutol 1.
Surgical intervention may be considered in cases of abscess formation or treatment failure 1.Special Populations
Tuberculosis incidence rates show gender differences by age group. In the 15-44 year age group, incidence rates are significantly higher in men (IRR 1.25) 1. The only excess in the female gender was observed in the 10-14 year age group (IRR 0.83) 1.Key Recommendations
Treatment of tuberculous PID requires a multi-drug anti-tuberculosis regimen for a minimum of six months 1. (Evidence: Moderate)
Standard first-line anti-tuberculosis drugs include isoniazid, rifampicin, pyrazinamide, and ethambutol 1. (Evidence: Moderate)
Consider surgical intervention for pelvic tuberculous abscesses or in cases of treatment failure 1. (Evidence: Weak)References
1 Peer V, Schwartz N, Green MS. Gender differences in tuberculosis incidence rates-A pooled analysis of data from seven high-income countries by age group and time period. Frontiers in public health 2022. link