ABSTRACT
@#Cases of cervical lesions have been rising steadily in the past decades. From inflammation to carcinogenesis, the cervix is never really spared of disease. In the presence of a cervical mass, malignancy is always a consideration. In this paper, we present three cases of cervical tuberculosis that were diagnosed in a tertiary private hospital in Pasay City. Women in their 3rd and 4th decade of life presenting with post coital spotting, copious vaginal discharge and amenorrhea were examined: The cervix was converted to a nodular friable mass, with extension to the fornices. On rectovaginal exam, both parametria were nodular but free from the pelvic sidewall. The primary consideration was a probable cervical carcinoma stage IIB. On tissue biopsy and further testing, cervical tuberculosis was confirmed. Quadruple anti-Koch’s therapy was initiated, to which clearing of the cervix with decrease discharge was noted.
Subject(s)
TuberculosisABSTRACT
Introduction: Scrofula also known as tuberculous cervical lymphadenitis is one of the most common manifestations of tuberculosis (TB). India is a country that still remains plagued by this dreaded disease. The disease poses both diagnostic and therapeutic challenges because it mimics other pathologic processes and does not have consistent physical and laboratory findings. The monitoring of treatment in cases of cervical TB lymphadenitis is more complex due to the peculiar behavior of TB lymph nodes. Materials and Methods: The serum alkaline phosphatase (ALP) of all patients presenting with cervical TB lymphadenitis in the Revised National TB Control Programme (RNTCP) outpatient department (OPD) of MS Ramaiah Medical College was collected. An ALP level at the time of diagnosis was noted. Subsequently, serum ALP levels were measured when the patients come for Directly Observed Treatment Short to RNTCP OPD on 15th, 30th, and 60th day of starting anti-TB treatment (ATT). Results: It has been observed in the study that 72.2% of the patients with cervical tuberculous lymphadenitis had significantly elevated levels of serum ALP (>135 IU/L) at the time of presentation. Only 5.3% among the controls had high ALP, and the difference was statistically significant with a P < 0.001. With sensitivity = 72.2% and specificity of 94.5%, and assuming that the prevalence of TB is 3.2% the estimated positive predictive value is 30.3% and negative predictive value is 99.0%. Based on simple linear regression with ALP as dependent variable and time as independent variable, it is found that among the patients there is a decline in ALP values at an average of 33.4 in every 15 days. Conclusion: This study shows the significance of measurement of serum ALP as a supplementary tool in the diagnosis of cervical TB lymphadenitis. Serial monitoring of serum ALP can be used to monitor the response of ATT.
ABSTRACT
[Objective]To assess the efficacy of autograft fusion and anterior spinal stabilization as an alternative treatment for tuberculosis lesion of the lower cervical spine. [Methods]Thirty patients with tuberculosis of the lower cervical spine underwent anterior decompression and fusion.There were 22 male and 8 female with the age from 24 to 58 years(mean age,37 years).The involved area included 2 vertebral bodies in 21 patients,3 vertebral bodies in 9 patients.Combined chemotherapy was delivered to each patient for at least three weeks preoperatively.There were 5 patients with Frankel Grade B,5 with Grade C,13 with Grade D and 7 with Grade E.The mean kyphosis angle were 12?.[Results]The patiets stood surgery well.The operation time was 70～100 min and the bleeding during operation was 50～150ml.There was no postoperative complication.All patients were followed up for 24～36 months.At the last follow-up visit,5 cases with Frankel Grade B improved to Grade D,3 cases with Grade C improved to Grade D,2 cases with Grade C improved to Grade E,13 cases with Grade D improved to Grade E.There was no breakage of nails or failure of the internal fixation during the follow up.Stable bone union was observed in all cases and the average time required for fusion were 6.5 months.[Conclusion]Anterior debridement and autograft with internal fixation is a safe and effective method for treatment of the lower cervical tuberculosis.
ABSTRACT
Tuberculosis of the uterine cervix is a rare disorder and the cervix is reported to be involved in 5-15 percent of the case of genital tuberculosis. It is discovered incidentally in most cases. The genital lesions are secondary to tuberculosis elsewhere, usually, the lungs. Primary cervical tuberculosis is very rare. The cytologic diagnosis of cervical tuberculosis is difficult. The histological diagnosis of genital tuberculosis presents no problems when the typical caseating necrosis and Langhans giant cell granulomas are present in tissue. And the presence of tubercle bacilli in biopsy specimens as well as in cultures of one specimen confirmed the diagnosis. We report a case of tuberculosis of the cervix confirmed by histologic examination with brief review.