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IB Suta, Hendrata,
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Seorang wanita dengan tuberkulosis genital IB Suta, Hendrata,
Medicina Vol 47 No 3 (2016): September 2016
Publisher : Medicina

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Abstract

Tuberkulosisgenitalhampir selalumerupakan prosessekunder lesi primerdibagiantubuhlainyangbersifat dorman. Sebagian besar infeksi mencapai saluran genital (terbanyak pada tubafallopi) melalui rute hematogen. Dapat juga terjadipenyebaran infeksi secararetrogradepadaovariumdanperitoneum.Transmisi langsungvulvadanserviksdari pasangan seksual yangterinfeksi jarang terjadi. Tuberkulosis genital dapat dicurigai dari riwayat kontak aktif denganpenderita tuberkulosis, dengan LED yang tinggi, kenaikan level CA-125 dan foto toraks yangmenunjukan lesi TB. Massa di adneksa, penebalan omentum, cairan kavum pelvik, danperlengketan dapat tampak pada USG pelvik. Pada laporan ini, kami menyampaikan kasusseorang perempuan umur 49 tahun dengan ditemukan penebalan endometrium pada USGtransvaginal. Lesi tipikal pada TB genital adalahepitheloid cell granulomasdengan atau tanpamultinucleated giants cellstipeLanghan’ syang didapatkan pada pemeriksaan histoPA darijaringan endometrium  pasien ini.Terapi pada pasien  iniobat anti tuberculosis(OAT)kategori1 dengan hasil pasien tidak lagi mengeluhkan perdarahan pervagina sejak 4 mingguterapi.[MEDICINA.2016;50(3):23-29].Genital TB is almost always the secondary process of dormant lesions in other body parts. The majority of genital tract infection reaches (most commonly in the fallopian tube) through hematogenous route. It can also spread retrograde to the ovaries and the peritoneum. Direct transmission vulva and cervix from an infected sexual partner is rare. Genital TB may be suspected in cases with active contact history with tuberculosis, high LED, the increase in CA125 levels and suspicious radiographic lesions relevant of TB. The presence of adnexal mass, thickening of the omentum, fluid in the pelvic cavity, and organ adhesions can be seen in pelvic ultrasound.In this report, we present the case of a woman 49 years old withtransvaginal ultrasound often reveals thickening of the endometrium. Genital lesions typical of TB are epithelioid cell granulomas with or without langhan’s typemultinucleated giants cellsobtained on histoPA examination of the endometrial tissue of patients.. Anti TB drugs category 1 therapy was started in this patient resulting in decreased vaginal bleeding after 4 weeks of therapy.