A18.17
Tuberculous female pelvic inflammatory disease
Clinical Classification Guidelines
Inclusion Terms
- Tuberculous endometritis
- Tuberculous oophoritis and salpingitis
Medical Intelligence & Overview
Tuberculous female pelvic inflammatory disease (FPID) is a rare but serious condition caused by the spread of tuberculosis (TB) bacteria to the female reproductive organs. It primarily involves the endometrium, ovaries, and fallopian tubes. This condition is a form of extrapulmonary tuberculosis and can lead to significant reproductive health complications if not properly diagnosed and managed. Recognizing the signs and understanding the underlying causes are essential for effective treatment and prevention.
Causes & Symptoms
Clinical Causes: Activation of dormant *Mycobacterium tuberculosis* bacteria that spread from other parts of the body, especially the lungs. Direct spread from adjacent infected tissues or organs within the pelvis. Hematogenous dissemination from a primary TB infection elsewhere in the body. Reactivation of latent TB infection within the pelvic organs.
Key Symptoms: Lower abdominal pain or discomfort Irregular menstrual bleeding or abnormal vaginal discharge Fever and night sweats Unintentional weight loss Pelvic mass or fullness General malaise and fatigue Dyspareunia (pain during sexual intercourse) Infertility or tubal blockages in chronic cases
Diagnostic & Treatment
Diagnosis Path: Diagnosing tuberculous pelvic inflammatory disease can be challenging due to its nonspecific symptoms. Healthcare providers may use a combination of approaches including: - Medical history review, focusing on TB exposure or prior treatment - Pelvic examinations - Imaging tests such as ultrasound or MRI to identify structural abnormalities - Laboratory analysis of vaginal or cervical samples for acid-fast bacilli - Histopathological examination of tissue biopsies - Tuberculin skin test or interferon-gamma release assays (IGRAs) - Culturing *Mycobacterium tuberculosis* from tissue or fluid samples A multidisciplinary approach usually helps confirm the diagnosis.
Treatment Protocols: Treating tuberculous female pelvic inflammatory disease involves a prolonged course of specific anti-tuberculosis medications. The typical treatment includes: - A combination of antibiotics such as isoniazid, rifampicin, ethambutol, and pyrazinamide - Medication duration often extends for at least 6 months - Surgical intervention may be necessary in cases involving abscess formation, significant structural damage, or obstructions - Close follow-up to monitor response to therapy and prevent recurrence - Supportive care, including managing symptoms and preventing complications Effective treatment can help resolve the infection, restore reproductive function, and prevent further damage.
Clinical Advice & FAQs
Billing Guidance
Is A18.17 a billable ICD-10 code?
Yes, A18.17 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report A18.17?
Clinical documentation must specify the nature of Tuberculous female pelvic inflammatory disease and any associated comorbidities for accurate reporting.
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