Unveiling Rare Cases of Genital Tuberculosis: A Two-Case Report Emphasizing Diagnostic Awareness

Abstract

Background: Female genital tuberculosis (FGTB) is a rare form of extrapulmonary tuberculosis that often mimics other gynecological pathologies, leading to diagnostic challenges and delayed treatment. In tuberculosis-endemic countries like Indonesia, awareness of this condition remains limited.

Methods: This study is a descriptive retrospective study that presents two case reports of female genital tuberculosis patients who were treated at Persahabatan General Hospital between 2023 – 2024. Both patients were referred from other hospital with two different diagnosis. The diagnosis in both cases was established through a combination of clinical evaluation, radiological imaging, and confirmatory pathological or bacteriological tests. 

Results: We reported two cases of FGTB in reproductive-age women. The first case, a 33-year-old woman, presented with abdominal pain, distension, and elevated CA-125 levels serum, raising suspicion of ovarian malignancy. Laparoscopy and histopathological examination confirmed tuberculosis infection, and the patient showed full recovery after nine months of anti-tuberculosis therapy. The second case, a 32-year-old woman with a history of pulmonary tuberculosis, was diagnosed early through ultrasonography findings and successfully managed with medical therapy followed-up by serial ultrasound, avoiding surgical intervention.

Conclusion: Many cases of female genital tuberculosis remain underdiagnosed due to the challenges in its diagnosis. Early recognition through careful examination, imaging, and confirmatory tests can prevent misdiagnosis and unnecessary surgery. Greater awareness and multidisciplinary among clinicians can also lead to early diagnosis, proper treatment, and better patient outcomes.