Correlation of different diagnostic techniques and laparoscopy with PCR in diagnosis of female genital tuberculosis

Aim: This study was done to evaluate polymerase chain reaction( PCR) and BACTEC culture in diagnosis of female genital tuberculosis. The findings of these diagnostic modalities were compared with that of direct microscopy and culture on Lowenstein-Jensen( LJ) medium and also with that of laparoscopy. Methods: Thirty clinically suspected cases of female genital tuberculosis were included in this study. Laparoscopy was done in each of the patient. Endometrial biopsy ( EB) was collected in each patient and sent to Microbiology and Pathology laboratory. Direct microscopy, culture on LJ medium and BACTEC were done for tuberculosis. PCR was done using two primers MPB64 and HupB for Mycobacterium tuberculosis. Histopathology was done in each sample to look out for granuloma and other features of chronic inflammation. Results:7(23.3%) samples were positive by PCR using MPB64 and Hup B primers. Positivity in other diagnostic modalities were 1 ( 3.3%), 2( 6.7%) and 4( 13.3%) for direct microscopy, culture on LJ medium and BACTEC medium respectively. None of the samples were positive on either LJ medium or BACTEC culture and negative by PCR. 3 out of 3 cases (100%) showing suggestive findings of tuberculosis in laparoscopy were positive by PCR. 5 out of 5 cases (100%) showing granuloma in histopathology were positive by PCR. Conclusions: Polymerase Chain Reaction (PCR) showed higher sensitivity and specificity than conventional techniques and showed good correlation with laparoscopic findings in diagnosis of female genital tuberculosis.