Tuberculous pelvic inflammatory disease infection

What are the infection routes of tuberculous pelvic inflammatory disease? Do you know the infection routes of tuberculous pelvic inflammatory disease? Do you want to know the infection routes of tuberculous pelvic inflammatory disease?

Female genital inflammation caused by tuberculosis is called genital tuberculosis, also known as tuberculous pelvic inflammatory disease. It is often found in women aged 20 to 40, and can also be seen in elderly women after menopause. The course of the disease is slow and hidden. The tuberculosis bacteria can be discharged with menstrual blood. The infection is mainly secondary, mainly from pulmonary and peritoneal tuberculosis. The transmission routes may be the following:

1) Hematogenous transmission: This is the main route of transmission. Tuberculosis bacteria first invade the respiratory tract. Animal experiments have shown that the injection of 2 to 6 tuberculosis bacteria can cause lesions and spread rapidly, forming lesions in the lungs, pleura or nearby lymph nodes, and then spread through the blood circulation to the internal reproductive organs, first the fallopian tubes, and gradually spread to the endometrium and ovaries. Infections of the cervix, vagina, and vulva are rare.

Studies have shown that if the primary lung infection occurs close to menarche, the possibility of spreading through the bloodstream (i.e., pre-sensitization bacteremia) and involving the reproductive tract is greatly increased. At this time, the tissue reaction is not obvious and there are no clinical symptoms.

Circulating tuberculosis bacteria can be cleared by the reticuloendothelial system, but can form latent metastatic lesions in the fallopian tubes. They can remain dormant for 1 to 10 years, or even longer, until certain factors cause local immunity to be weakened, latent lesions are reactivated, and the infection recurs.

Because this slow, asymptomatic process often results in the complete absorption of the primary lesions in the lungs without leaving any radiologically diagnostic traces, this is almost a universal phenomenon when genital tuberculosis is diagnosed.

2) Direct spread in the abdominal cavity: When tuberculous peritonitis, caseous changes in mesenteric lymph nodes rupture, or intestinal and bladder tuberculosis are extensively adhered to the internal reproductive organs, the tuberculosis bacillus can spread directly to the surface of the reproductive organs. Tuberculosis of the fallopian tubes often coexists with peritoneal tuberculosis. It is possible that the tubes first spread to the peritoneum, or vice versa. It is also possible that both are the result of hematogenous spread.

3) Lymphatic transmission: The bacteria spread from tuberculosis lesions in abdominal organs, such as intestinal tuberculosis, to the internal reproductive organs through the lymphatic vessels in a retrograde manner. Since retrograde spread is required, it is rare.

4) Primary infection: The possibility of direct infection of female reproductive organs with tuberculosis and the formation of primary lesions is still controversial. Although male patients with urogenital tuberculosis (such as epididymal tuberculosis) directly infect their sexual partners through sexual intercourse and form primary vulvar or cervical tuberculosis, this has been reported in the literature, but tuberculosis bacilli are not often found in semen, and in these cases it is impossible to exclude the existence of early asymptomatic primary lesions in the lungs or other parts.