vulvar tuberculosis
Introduction
Introduction to vulvar TB Vulvar tuberculosis is very rare, occasionally secondary to severe lung, digestive tract, thoracic peritoneum or internal genital tuberculosis. Patients often have no typical symptoms and need to rely on auxiliary diagnostic methods for diagnosis and differential diagnosis. basic knowledge Sickness ratio: 0.0001% Susceptible people: women Mode of infection: non-infectious Complications: tuberculosis, kidney tuberculosis, infertility
Cause
Causes of vulvar tuberculosis
Exposure to infection (20%):
Vulvar tuberculosis is mostly caused by internal genital tuberculosis or renal tuberculosis. It can also be infected by external contact such as sputum or sexual intercourse (primary vulvar tuberculosis). A small number of vulvar tuberculosis may not find primary tuberculosis, and children with vulvar tuberculosis are mostly due to parents. Have tuberculosis and get infected.
Blood infection (20%):
Mycobacterium tuberculosis in the body tuberculosis can be directly inoculated into the vulvar skin mucosa through the blood, lymphatic system or adjacent tuberculosis lesions. When the internal organs have active tuberculosis, and the patient's resistance to tuberculosis is low, the tubercle bacilli in the body excretion can pass. Damage to the skin or mucous membranes and infection of the mouth.
Pathogen infection (20%):
Pathological changes common macrophages and caseous necrosis, pus smear or culture can be found Eosinophilus, tuberculosis aerobic, high nutritional requirements, under good conditions, still grow slowly, 18 ~ 24h to breed a generation (general The bacteria are grown for 20min on average. The pathogens are human and bovine tuberculosis. The former first infects the lungs, while the latter infects the digestive tract and then spreads to other parts of the body through various routes, including vulva and inguinal lymph nodes. When affected, suppuration can be formed, and scars will be formed later. Because of spouse with epididymal tuberculosis or renal tuberculosis, the lesions transmitted by sexual intercourse often occur in the labial ligament, the body's resistance to tuberculosis, allergies, the number of invading bacteria and its toxicity. The strength of the disease is related to the severity of the disease.
Prevention
Vulvar tuberculosis prevention
Early vaccination, exercise, strengthen the body's resistance, prevent tuberculosis infection.
Complication
Vulvar tuberculosis complications Complications, tuberculosis, renal tuberculosis, infertility
Often accompanied by visceral tuberculosis, such as tuberculosis, kidney tuberculosis, infertility.
Symptom
Vulvar tuberculosis symptoms Common symptoms Perineal ulcers Sexual intercourse Painful edema Nodules P) Chronic ulcers
Vulvar tuberculosis is divided into two types: ulcer and hyperplasia. The vulva often has ulcers that have not healed for a long time. Vulvar tuberculosis occurs in the labia minora or vestibular mucosa. The development is slow. The ulcer type is red pimples or a localized nodule. Section, but quickly ulcerated to form an ulcer, the edge of which is soft, thin and not neat, or a hard oval ulcer, the ulcer base surface is uneven, the pale granulation tissue is covered with yellow cheese-like material, and the lesion can spread to the perineum , urethra and anus, can form fistula, and deform the labia, local lymph nodes often enlarge, or secondary vulva and lower extremity lymphedema, vulvar tuberculosis itself does not cause pain, but friction or urine stimulation can induce severe pain, proliferative type Like vulvar elephant skin disease, vulvar hypertrophy, dysuria, sexual inconvenience or painful intercourse.
Examine
Inspection of vulvar tuberculosis
Pus smear can be found in tuberculosis, positive for tuberculosis test, lymphocyte increase in white blood cell classification, rapid blood sedimentation during active period, pathological histological examination such as tuberculosis lesions can be confirmed in the section, but if there is no tuberculosis The existence of giant cell system can not deny the existence of no tuberculosis. It needs to be reviewed after 3 months. If the endometrial examination is negative, it can be considered that there is no tuberculosis in the endometrium.
X-ray examination: chest X-ray film: if necessary, the gastrointestinal system and the urinary system film to find the primary lesion, but some patients have genital tuberculosis, the primary lesion has healed.
Diagnosis
Diagnosis of vulvar tuberculosis
The genital area has chronic ulcers that have not healed for a long time, and those with other tuberculosis in the body should be suspected of being vulvar tuberculosis. The diagnosis depends mainly on the secretion smear for tuberculosis or biopsy to confirm the diagnosis.
Ulcerative vulvar tuberculosis needs to be differentiated from general vulvar ulcers, syphilitic ulcers, soft chancre, and vulvar cancer.
