tuberculous vaginitis
Introduction
Introduction to tuberculous vaginitis Tuberculous vaginitis is caused by infection of Mycobacterium tuberculosis. Tuberculous vaginitis is a manifestation of genital tuberculosis. It is mostly secondary infection. Due to the slow course of the disease, the form of expression is not typical, so it is easy to be Neglect. basic knowledge The proportion of illness: 0.03% Susceptible people: women Mode of transmission: sexual transmission Complications: endometritis
Cause
Causes of tuberculous vaginitis
Causes:
Tuberculous vaginitis mainly comes from tuberculosis, peritoneal tuberculosis, and causes tuberculous vaginitis. There are three reasons and ways: 1. Patients with blood circulation have active tuberculosis, history of tuberculosis or bone tuberculosis, and spread through blood. 2. Direct spread is caused by severe pelvic tuberculosis and infection of the cervix and vagina. 3. Primary infection due to severe testicular tuberculosis, seminal vesicle tuberculosis or ulcerative lymph node tuberculosis in men, through sexual intercourse.
Pathogenesis:
The pathogen of tuberculous vaginitis is an acid-resistant tubercle bacillus. According to the metabolism and growth characteristics of tuberculosis, the tuberculosis group in tuberculosis is divided into four categories. 1. Group A: Early active tuberculosis, which is abundant in the early active lesions. 2. Group B: The amount of macrophages grown in an acidic environment as the disease progresses, the amount is small. 3. Group C: It is slow or intermittent reproduction in neutral cheese lesions. 4. Group D: It is dormant and does not reproduce at all. The above four groups of tuberculosis have different responses to anti-tuberculosis drugs. Group D tuberculosis does not work for any drugs, and can only be removed by the body's immune function, or the bacteria themselves die.
Prevention
Tuberculosis vaginitis prevention
Most of the vaginal tuberculosis is secondary infection. The primary lesions are mostly tuberculosis. The preventive measures are the same as tuberculosis. It is necessary to strengthen the anti-tuberculosis publicity and education, enhance physical fitness and nutrition, and strengthen children's health care. Now the anti-tuberculosis organization regulates the birth of newborns. More than 2200g, born more than 24h, can be given BCG, less than 2200g or not BCG after birth, can be replanted within 3 months, 3 months after the baby is tested for tuberculin, if negative, Can be vaccinated, adolescent girls with tuberculin test negative, should be BCG vaccination, pregnancy should be avoided during the active period of tuberculosis.
Complication
Tuberculous vaginitis complications Complications endometritis
Combine other pathogen infections.
Symptom
Tuberculosis vaginitis symptoms Common symptoms Lower abdominal pain Abdominal pain Weight loss Bladder vaginal inguinal lymphadenopathy Amenorrhea Lower abdomen vaginal discharge Low urinary frequency
Many patients with tuberculous vaginitis have normal appearance and no obvious complaints. Some patients with vaginal tuberculosis often complain of vaginal discomfort, pain, tenderness, and white or brown-black secretions in the vagina. Those with severe illness may have poor appetite and low fever. Systemic symptoms such as weight loss, secondary to tuberculosis in the lungs, peritoneum, intestines, joints, etc., and tuberculosis in the urinary system, so symptoms such as pleural pain, abdominal pain, frequent urination, hematuria, etc. may occur in the symptoms. When tuberculosis such as fallopian tubes, uterine tuberculosis, etc., accompanied by other organs of the genitals, there may be infertility, lower abdominal pain, abnormal menstruation, vaginal discharge is a large number of purulent or serous vaginal discharge, and the lesion often has two forms: Ulcer type and hyperplasia type, often invasive at the beginning of the lesion, swollen, and then gradually become ulcers, often with multiple hair styles, the base of the ulcer is yellow, there may be granules, local tenderness, scar formation after ulcer healing The vaginal stenosis, swollen inguinal lymph nodes, the formation of sinus or vesicovaginal fistula and rectal vaginal fistula after ulceration, ulcers and sinus have a lot of purulent or serous Secretion flow out, locally tenderness.
Examine
Tuberculosis vaginitis examination
1. Vaginal secretion smear looking for acid-resistant tubercle bacilli.
2. Histopathological examination.
3. Culture of Mycobacterium tuberculosis and animal inoculation, observe whether there is no positive result when the vaginal secretion of Mycobacterium tuberculosis culture reaches 2 months; or inoculate these secretions on the abdominal wall of guinea pigs, and anatomical examination after 6-8 weeks, such as the inoculation site If the tubercle bacillus is found in the surrounding lymph nodes, it can be diagnosed. This method has certain technical requirements and it takes a long time to be used.
4. Polymerase chain reaction (PCR) PCR amplification of Mycobacterium tuberculosis DNA diagnosis is a more sensitive and rapid method, but the judgment results should be considered in relation to the course of the disease.
5. Other inspections
For example, tuberculin test, generally negative means no tuberculosis infection, positive indicates that there is tuberculosis infection, strong positive indicates that there are still active lesions in the body, but there is no certain value for the lesion, the number of white blood cells is generally not high, the lymphocytes in the classification Increased, increased erythrocyte sedimentation rate during the active period can also be used as a reference for diagnosis.
6. X-ray diagnosis
Including chest X-ray, abdominal X-ray, uterine fallopian tube iodine angiography.
7. Uterus, laparoscopy.
Diagnosis
Diagnosis and diagnosis of tuberculous vaginitis
Tuberculous vaginitis must be differentiated from vulvovaginal genital warts (condyloma acuminata or flat warts), sexually transmitted diseases, granuloma, cancer, etc. The method mainly depends on biopsy. Because human immunodeficiency virus (HIV) infection is prone to tuberculosis, it is All tuberculosis patients, especially those in urban areas, should undergo HIV testing to detect AIDS patients in a timely manner. There have been reports of AIDS patients in tuberculosis patients in China.
