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Tubercular endometritis detected through Pap smear campaign in Enugu, Nigeria.
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MedLine Citation:
PMID:  22593783     Owner:  NLM     Status:  MEDLINE    
In a series of 3,267 cervical smears examined in Enugu, Nigeria, from 1993 through 2010, there was a single positive case of tuberculosis (TB). It was found in a 55-year-old, Para 7, postmenopausal woman. Treatment for tuberculosis was instituted successfully.
Wilson Onuigbo; Bessie Esimai; Chinenye Nwaekpe; Grace Chijioke
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Publication Detail:
Type:  Case Reports; Letter     Date:  2012-03-15
Journal Detail:
Title:  The Pan African medical journal     Volume:  11     ISSN:  1937-8688     ISO Abbreviation:  Pan Afr Med J     Publication Date:  2012  
Date Detail:
Created Date:  2012-05-17     Completed Date:  2012-08-23     Revised Date:  2013-06-24    
Medline Journal Info:
Nlm Unique ID:  101517926     Medline TA:  Pan Afr Med J     Country:  Uganda    
Other Details:
Languages:  eng     Pagination:  47     Citation Subset:  IM    
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MeSH Terms
Antitubercular Agents / therapeutic use
Endometritis / diagnosis*,  drug therapy,  pathology
Middle Aged
Tuberculosis / diagnosis*,  drug therapy,  pathology
Vaginal Smears* / methods
Reg. No./Substance:
0/Antitubercular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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Journal Information
Journal ID (nlm-ta): Pan Afr Med J
Journal ID (iso-abbrev): Pan Afr Med J
Journal ID (publisher-id): PAMJ
ISSN: 1937-8688
Publisher: The African Field Epidemiology Network
Article Information
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© Wilson Onuigbo et al.
Received Day: 09 Month: 5 Year: 2011
Accepted Day: 12 Month: 3 Year: 2012
Electronic publication date: Day: 15 Month: 3 Year: 2012
collection publication date: Year: 2012
Volume: 11E-location ID: 47
ID: 3343675
PubMed Id: 22593783
Publisher Id: PAMJ-11-47

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 Center, 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.

1. Abdulla LS. Pattern of abnormal Pap smears in developing countries: A report from a large referral hospital in Saudi Arabia using the 2001 revised Bethesda SystemAnn Saudi Med.Year: 20072726827217684431
2. Cicinelli E,Tinelli R,Colafiglio G,et al. Tubercular endometritis: a rare condition reliably detectable with fluid hysteroscopyJ Minim Invasive Gynecol.Year: 20081575275418971142
3. Dabao Xu,Min Xue,Xueying Han. Hysteroscopic images of early-stage endometrial tuberculosisGynecological Surgery.Year: 2008615152
4. Basden GT. Niger IbosYear: 1966LondonCass
5. Onuigbo WIB. Genital tuberculosis and reproductive functionJ Reprod Med.Year: 197821249250739479
6. Ojo BA,Akanbi AA,Odimayo MS,et al. Endometrial tuberculosis in the Nigerian middle belt: an eight-year reviewTrop Doct.Year: 2008383418302848

Article Categories:
  • Letter to the Editors

Keywords: Tuberculosis, endometrium, Pap smear, health education, Nigeria.

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