Tubercular endometritis detected through Pap smear campaign in Enugu, Nigeria
Wilson Onuigbo, Bessie Esimai, Chinenye Nwaekpe, Grace Chijioke
The Pan African Medical Journal. 2012;11:47. doi:10.11604/pamj.2012.11.47.817

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Letter to the editors

Tubercular endometritis detected through Pap smear campaign in Enugu, Nigeria

Cite this: The Pan African Medical Journal. 2012;11:47. doi:10.11604/pamj.2012.11.47.817

Received: 09/05/2011 - Accepted: 12/03/2012 - Published: 15/03/2012

Key words: Tuberculosis, endometrium, Pap smear, health education, Nigeria

© Wilson Onuigbo et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/11/47/full

Corresponding author: Wilson Onuigbo, Department of Histopathology, National Orthopaedic Hospital, Enugu, Nigeria (wilson.onuigbo.@gmail.com)


Tubercular endometritis detected through Pap smear campaign in Enugu, Nigeria

 

Wilson Onuigbo1,&, Bessie Esimai1, Chinenye Nwaekpe2, Grace Chijioke3

 

1Department of Histopathology, National Orthopaedic Hospital, Enugu, Nigeria, 2Department Microbiology National Orthopaedic Hospital, Enugu, Nigeria, 3Medical Women’s Cente, Enugu, Nigeria

 

 

&Corresponding author
Wilson Onuigbo, Department of Histopathology, National Orthopaedic Hospital, Enugu, Nigeria

 

 

To the editors of the Pan African Medical Journal

A rare case of tubercular endometritis occurred in a 55-year-old Para 7, postmenopausal woman, who presented herself for cervical smear at the Medical Women’s Centre in Enugu, the capital of Enugu State of Nigeria. The senior author (WO) observed at microscopy the diagnostic Langhans giant cells. This was the only case encountered among 3,267 smears examined between 1993 and 2010. Subsequently, laboratory tests were carried out. The Mantoux test was positive at 14 mm. The ESR measured 52 mm in the first hour. The Total White Count was 7,200/mm³. The differential count showed Neutrophils 51%, Lymphocytes 35%, Eosinophils 13%, and Monocytes 1%. Treatment for tuberculosis was instituted and the follow up has been successful.

 

Pattern of abnormal Pap smears in developing countries is of epidemiological interest. In a Saudi Arabian series [1], there was no mention of tuberculosis. In an Italian study [2], tubercular endometritis was recorded as a rarity which was detected with fluid hysteroscopy. A Chinese study [3] indicated that this disease may cause uterine adhesions, amenorrhea, and subsequently infertility.

 

A previous report on the easterly Igbos or Ibos [4], one of the largest ethnic groups in Nigeria, led to the following conclusion [5]: “Igbo women conceive and give birth before the onset of genital tuberculous lesions that lead to primary infertility.” The parity of 5 in the instant case is in keeping with this conclusion. Agreeably, as a study [6] centered in the Nigerian middle belt stated, “Endometrial TB is not a frequent cause of infertility in our set-up.”

 

 

Authors’ contributions

WO: pathologist who analyzed the smear and reviewed the pathology literature. BE: chief medical laboratory scientist who prepared the smear. CN: senior medical laboratory scientist who carried out tests on the patient. CE: matron in charge of smear campaign

 

 

Competing interests

The authors declare no competing interest.

 

 

References

  1. Abdulla LS. Pattern of abnormal Pap smears in developing countries: A report from a large referral hospital in Saudi Arabia using the revised 2001 Bethesda System. Ann Saudi Med. 2007; 27: 268-272. This article on PubMed

  2. Cicinelli E, Tinelli R, Colafiglio G, et al. Tubercular endometritis: a rare condition reliably detectable with fluid hysteroscopy. J Minim Invasive Gynecol. 2008; 15:752-754. This article on PubMed

  3. Dabao Xu, Min Xue and Xueying Han. Hysteroscopic images of early-stage endometrial tuberculosis. Gynecological Surgery. 2008;6(1):51-52

  4. Basden GT. Niger Ibos. London: Cass; 1966

  5. Onuigbo WIB. Genital tuberculosis and reproductive function. J Reprod Med. 1978; 21:249-250. This article on PubMed

  6. Ojo BA, Akanbi AA,Odimayo MS, et al. Endometrial tuberculosis in the Nigerian middle belt: an eight-year review. Trop Doct. 2008; 38:3-4. This article on PubMed

 

 

 

 

 

 

 

 

 

 


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