REPRODUCTIVE TRACT INFECTIONS DUE TO Mycobacterium tuberculosis

1. Due to Mycobacterium tuberculosis
Presented By:
Sangram P. Ramane
PhD Scholar
Roll no. 1447
DIVISION OF BACTERIOLOGY AND MYCOLOGY, IVRI
Assignment
On
BACTERIAL INFECTIONS OF REPRODUCTIVE SYSTEMS
REPRODUCTIVE TRACT INFECTIONS

2. INTRODUCTION
 Tuberculosis is a chronic infection,
potentially of lifelong duration.
 M. tuberculosis, first discovered in 1882 by
Robert Koch causative agent of most cases of
tuberculosis.
 Spread through airborne particles that contain
M. tuberculosis, called droplet nuclei.
 The disease is confined to the lungs in most
patients but may spread to almost any part of
the body.

3. CAUSATIVE AGENT
 Acid-fast, Gram-positive
 Non motile, non spore forming, highly
aerobic bacteria.
 Divides every 15–20 hours
 Can’t tolerate heat but can withstand weak
disinfectants and can survive in a dry state
for weeks
 Unusual cell wall, rich in lipids (e.g., mycolic
acid), is likely responsible for this resistance
and is a key virulence factor.

4. PATHOGENESIS
 TB infection begins when the mycobacteria
reach the pulmonary alveoli.
 Invade and replicate within endosomes of
alveolar macrophages.
 The primary site of infection in the lungs,
known as the "Ghon focus“
 Macrophages, T, B cells and fibroblasts are
among the cells that aggregate to form
granulomas.
 The granuloma prevents dissemination of
the mycobacteria

5. EXTRA-PUMONARY TB
 Bacteria inside the granuloma can become dormant, resulting in latent
infection.
 Another feature of the granulomas is the development of abnormal
cell death (necrosis) in the center of tubercles.
 If TB bacteria gain entry to the bloodstream from an area of damaged
tissue, they can spread throughout the body and set up many foci of
infection.
 In 15–20% of active cases, the infection spreads outside the respiratory
organs, causing other kinds of TB: “Extrapulmonary tuberculosis".

6. SITES OF TUBERCULOSIS
 Pulmonary TB occurs in the lungs
 85% cases
 Extrapulmonary TB
 Larynx
 Lymph nodes
 Brain and spine
 Kidneys
 Bones and joints
 Reproductive organs
 Miliary TB occurs when tubercle
bacilli enter the bloodstream and
are carried to all parts of the body

7. GENITAL TUBERCULOSIS
 Genital tuberculosis is always secondary to tuberculosis.
 Blood stream most common but direct spread from peritoneum and
sexual transmission by infected partner.
 FEMALE REPRODUCTIVE TRACT INFECTINS
 Fallopian tubes
 Endometrium
 Ovaries and cervix
 Vagina and vulva
 MALE REPRODUCTIVE TRACT INFECTIONS
 General
 Epididymal
 Prostatic

8. CLINICAL PROFILE IN FEMALE
 Infertility due to lesions in endometrium and
fallopian tubes and a blockage of ovum
transport
 Chronic pelvic pain, persistent leucorrhoea
and pyometra and reproductive cycle
disorders
 Red and oedematous and fibrosed
appearance and extensive pelvic adhesions
 Endometrial ulcer or accumulation of
caseous material to form pyometra.
 Tuberculous lesions of the cervix present
with postcoital bleeding, abnormal discharge

9. CLINICAL PROFILE IN MALE
 Formation of granulomas in epididymis may
result in infertility
 Painful unilateral enlargement of the
scrotum
 In prostatic TB, Sterile urethral discharge,
terminal hematuria, dysuria and perineal
pain
 Tender testicular or epididymal swelling,
beading of the spermatic cord, and
epididymocutaneous sinus formations may
develop.
 Vas deferens may be enlarged and beaded

10. DIAGNOSIS
 Routine Tests: Tuberculin skin test
 Serial early-morning urine cultures for acid-fast bacilli. Also Semen
Analysis, Sputum Testing
 Luciferase and Fluorescent Techniques
 Radiography, CT Scanning, MRI, Ultrasonography, Image-Intensifier
Endoscopy
 Vasography and Hysterosalpingography
 Fine-needle aspiration (FNA) as a minimally invasive technique plays a
prime role in the diagnosis of tubercular epididymitis and epididymo-
orchitis.
 Polymerase Chain Reaction, DNA Probes, HPLC Test, etc

11. TREATMENT

12. Thank you…