What are the symptoms of tuberculous cervicitis?

Cervicitis is a common gynecological inflammation. Tuberculous cervicitis can cause infertility, menstrual disorders, lower abdominal pain, in addition to fever, fatigue, loss of appetite, weight loss symptoms. The most common cause of tuberculous cervicitis is hematogenous transmission.

1. Symptoms and Signs

1. Infertility

Most patients with genital TB present with infertility. Genital tuberculosis is one of the common causes in patients with primary infertility. Due to the destruction and adhesion of the fallopian tube mucosa, the lumen of the tube is often blocked; or due to adhesions around the fallopian tube, the lumen sometimes remains partially open, but the mucosal cilia are destroyed, the fallopian tube becomes stiff, the peristalsis is restricted, and the transport function is lost; endometrial tuberculosis hinders the implantation and development of the fertilized egg, and can also cause infertility.

2. In the early stage of menstrual disorders, due to endometrial congestion and ulcers, there may be excessive menstrual flow; in the late stage, due to varying degrees of damage to the endometrium, it manifests as infrequent menstruation or amenorrhea. Most patients are in the advanced stage when they seek medical treatment.

3. Lower abdominal pain Due to pelvic inflammation and adhesions, there may be varying degrees of lower abdominal pain, which worsens during menstruation.

4. Systemic symptoms

If it is in the active stage, there may be general symptoms of tuberculosis, such as fever, night sweats, fatigue, loss of appetite, weight loss, etc. In mild cases, systemic symptoms are not obvious, and sometimes only fever occurs during menstruation. Fever during menstruation is one of the typical clinical manifestations of genital tuberculosis. In severe cases, there may be systemic poisoning symptoms such as high fever.

5. General and gynecological examination

Due to the large differences in the degree and scope of the lesions, many patients are found to have pelvic tuberculosis when undergoing diagnostic curettage, hysterosalpingography and laparoscopy for infertility, without obvious physical signs or other subjective symptoms. If the patient also suffers from peritoneal tuberculosis, the abdomen will feel soft or have signs of ascites during examination. When encapsulated effusion is formed, a cystic mass can be felt with unclear boundaries and no movement. The surface may make a hollow sound when percussed due to intestinal adhesions. Cervical tuberculosis may present with papillary hyperplasia and small ulcers.

2. Pathological Causes

Cervical tuberculosis often spreads from endometrial tuberculosis or spreads through the lymphatic or blood circulation.

1. Hematogenous transmission

During adolescence, the reproductive organs develop and the blood supply is abundant, so Mycobacterium tuberculosis can easily spread through the blood. After Mycobacterium tuberculosis infects the lungs, it can infect the internal reproductive organs within about a year. Because the fallopian tube mucosa is conducive to the latent infection of Mycobacterium tuberculosis, Mycobacterium tuberculosis first invades the fallopian tubes and then spreads to the endometrium and ovaries in turn, and rarely invades the cervix, vagina or vulva.

2. Direct spread: Peritoneal tuberculosis and intestinal tuberculosis can spread directly to the internal reproductive organs.