Genital tuberculosis in a tamoxifen-treated postmenopausal woman with breast cancer and bloody vaginal discharge

• Published in: Annals of clinical microbiology and antimicrobials Vol. 5; no. 1; p. 20
• Main Authors: Neonakis, Ioannis, Mantadakis, Elpis, Gitti, Zoe, Mitrouska, Ioanna, Manidakis, Louis George, Maraki, Sofia, Samonis, George
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 01-09-2006; BioMed Central; BMC
• Subjects: Anti-Bacterial Agents - therapeutic use; Antineoplastic Agents, Hormonal - adverse effects; Breast Neoplasms - drug therapy; Case Report; Drug Therapy, Combination; Female; Humans; Middle Aged; Mycobacterium tuberculosis; Postmenopause; Tamoxifen - adverse effects; Treatment Outcome; Tuberculosis, Female Genital - drug therapy; Tuberculosis, Female Genital - etiology
• ISSN: 1476-0711; 1476-0711
• DOI: 10.1186/1476-0711-5-20

Female genital tuberculosis is an uncommon disease that is rarely diagnosed in developed countries.
A 61-year-old postmenopausal woman who had undergone surgery and treated with adjuvant chemotherapy for infiltrating ductal carcinoma of the breast five years ago, presented with bloody vaginal discharge, fatigue, weight loss, and low grade fevers at night for two months. Histological examination of the endometrium, done based on the suspicion of a second primary cancer due to the tamoxifen therapy, revealed a granulomatous reaction. Liquid and solid mycobacterial cultures of the tissues were performed. Although the acid fast staining was negative, the liquid culture was positive for Mycobacterium tuberculosis. Involvement of other systems was not detected. The patient was treated with a three-drug antituberculosis regimen for 9 months and recovered fully.
Female genital tuberculosis is a rare but curable disease that should be included in the differential diagnosis of women with menstrual problems. Early diagnosis is important and may prevent unnecessary invasive procedures for the patient.