A 19-year-old nulliparous woman is diagnosed with genital tuberculosis. Her chest radiograph is normal and she has no current respiratory symptoms. What is the usual mode of spread of infection to her genital tract?
- A Direct extension from an infected sexual partner via the cervix
- B Haematogenous spread from a primary pulmonary focus, often with reactivation years later ✓
- C Lymphatic spread from inguinal lymph nodes
- D Ascending spread from gastrointestinal tract through the peritoneum
Correct answer: B. Haematogenous spread from a primary pulmonary focus, often with reactivation years later
Explanation
Female genital tuberculosis is almost always secondary. Mycobacteria reach the genital tract haematogenously from a primary pulmonary focus, which may have healed silently, so the chest radiograph is normal in most cases. Reactivation typically occurs years after the primary infection, often presenting as infertility. Ascending venereal transmission is extremely rare because the tubercle bacillus is not transmitted sexually, and lymphatic spread from inguinal nodes is not the described pathway.
Reference: Berek and Novak's Gynecology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.