Case report

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

Ioannis Neonakis¹ , Elpis Mantadakis² , Zoe Gitti¹ , Ioanna Mitrouska³ , Louis George Manidakis⁴ , Sofia Maraki¹ and George Samonis²

¹  Laboratory of Mycobacteriology, Department of Clinical Bacteriology, Parasitology, Zoonoses, and Geographical Medicine, University Hospital of Heraklion, 712 01 Heraklion, Crete, Greece

²  Department of Internal Medicine, University Hospital of Heraklion, 712 01 Heraklion, Crete, Greece

³  Department of Thoracic Medicine, University Hospital of Heraklion, 712 01 Heraklion, Crete, Greece

⁴  Department of Obstetrics and Gynecology, University Hospital of Heraklion, Heraklion, Crete, Greece

author email corresponding author email

Annals of Clinical Microbiology and Antimicrobials 2006, 5:20doi:10.1186/1476-0711-5-20

Published:	1 September 2006

Abstract

Background

Female genital tuberculosis is an uncommon disease that is rarely diagnosed in developed countries.

Case presentation

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.

Conclusion

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.