Tubercolosi a sintomatologia di febbre malarica

Tubercolosi a sintomatologia di febbre malarica

January, 1934] GENITAL TUBERCULOSIS only 45 oases could be found, scattered in the literature, of wbich the first was one reported by Spencer Wells ...

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January, 1934]

GENITAL TUBERCULOSIS

only 45 oases could be found, scattered in the literature, of wbich the first was one reported by Spencer Wells in 1863. The diagnosis has never been made clinically--in other words, there is nothing d i s t i n c t i v e about the s y m ptomatology. Cases bave been divided into two groups : (a) Simple cases, with ~uberculous nodules, single or multiple, on the external wall of the c y s t ; or lesions on the inner surface of the cyst, with the formation of intraeystio vegetation and of caseous pus which gives the cyst the appearance of a cold abscess. (b) Complex cases: tuberculous tube-ovarian c y s t s ; or tuberculous cysts with important lesions of the peritoneum and neighbouring organs. The writers record a new case o[ their o w n - - a woman, a g e d 40, who twenty years previously had had an hysterectomy with unilateral castration for a suppurative infection following abortion. She gave a two years' history of an abdominal swelling in the left iliac fossa which when seen had attaindd the size of a small melon. At operation a mucoid cyst was found adherent to the bladder and to the rectum. Microscopic examination showed a racemose cyst, with tuberculous follicular nodules on its surface. The patient made a satisfactory recovery. LAPEYRE, N. C., and FAYOT, J. Double abc~s froid t u b a i r e avee torsion d ' u n des p y o s a l p y n x . B. de la See. d'Obst~t, et de Gyn., 1933, i, 76. T h e writers report a case ot cold abscess of both t u b e s - - a comparative]:~" rare type o f genital tuberculosis. The patient, a woman, ao~ed 25, gave a seven months' history of pain in the lower abdomen, with two severe acute attacks lasting t~fo or three days. The earlier bistory left no d o u b t as to the tuberculous nature of the lesion, but under medical treatment she improved for a time. :Recurrence of severe abdominal pain led to an operation, when a double pyo~alpingitis was found to be present, with torsion of the pedicle of the right tube. A salpingeetomy was carried out on tbe left side and tSe right ovary removed, the uterus and the left ovary being left i1~ situ. E a c h

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pyosalpinx contained about 300 to 500 c.c. of bacteriologically sterile pus. The writers d i s c u s s the question whether in the case of bilateral cold abscess of the tubes a total castration or a conservative operation should be performed~ The patient is nearly alw,~ys a young woman, and when, as In this case, a complete excision of the lesions can be carried out, a" conservative operation seems to be all that is required. P E L L E G R I N I , F. Tubercolosi a siutomatologia di febbre malarica. Tubercolosi, 1933, 25, 257. The writer records the case of a man, aged 27, who developed left orchiepididy,nitis without any previous gonorrhma or trauma, and some time afterwards had a series of attacks of intermittent fever. The blood was not examined, but no benefit was derived from quinine treatment, and during an attack of coughing some blood was expectorated. No tubercle bacilli were found in the sputum, but X-rays showed enlargement of the hilar glands and an infiltration of the lung of the miliariform type. The issue of the case is not recorded. YELINOFF, G . G . Les abc~s froids tubcreuleux ovariens. "_l'ld,ses de 3font~ellier, 1932-33, No. 22. Tuberculous cold abscesses of the ovary are a rare occurrence, as the writer has been able to collect only 21 examples, of which 75 per cent. were in patients between the ages of 15 and 35. They m a y be an isolated phenomenon or be associated with other genital lesions. Infection may take place by the genital tract, the blood, ly,nph or direct contact. I t is almost impossible to recognise the condition clinically, and as a rule histological examination is necessary. The prognosis is graver in the case o[ lesions confined to the ovary than in tubeovarian disease. The best treatment consists in removal of any suspected lesion or better still in subtotal hysterectomy associated with medical treatment.