TEXTBOOK OF PEDIATRIC GYNECOLOGY - 2013

Chapter 4. EXAMINATION METHODS IN PEDIATRIC GYNECOLOGY

DIAGNOSIS OF GENITAL TUBERCULOSIS IN GIRLS

In girls, Diagnosis is based on a combination of diagnostic approaches rather than on any single method. A relevant medical and epidemiological history, Complaints of abdominal pain, Algodysmenorrhea, weakness, asthenia, and low-grade fever provide grounds for a targeted examination of the patient.

Abdominal Palpation may reveal a positive Braude's sign — Muscle guarding over the area of the affected fallopian tubes.

Unlike in adults, rectoabdominal examination rarely reveals enlargement and induration of the adnexa. Any adnexal mass, if present, tends to be mildly tender and shows little change despite non-specific anti-inflammatory Treatment, which AIDS in Differential diagnosis. Occasionally, Hegar's sign can be elicited, presenting as lentil-sized or larger nodules palpable in the pouch of Douglas.

Hysterosalpingography, provided the hymenal opening is sufficiently elastic, allows visualization of fallopian tube displacement due to peritubular adhesions, tubal dilation, impaired tubal patency, and occasionally, tubal obliteration.

Cytological examination of uterine cavity aspirate (detecting elements of a tuberculous granuloma) has significant diagnostic value. Uterine curettage should not be performed for this purpose. Histological examination of biopsy sections triples the detection rate of tuberculosis.

Provocative tuberculin test (PTT): subcutaneous administration of 20 or 50 TU of tuberculin is evaluated based on general and focal reactions. A positive Mantoux test (induration greater than 10 mm in diameter) and a positive systemic reaction (Temperature increase of 0.7 °C) indicate a generalized tuberculosis infection, whereas a positive focal reaction helps establish the topographic diagnosis. Protein Electrophoresis is recommended before and after the PTT, as a decrease in the albumin-globulin ratio is observed in 45% of patients with an active tuberculous process.



Last update: 08/08/2026

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