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Non Tuberculosis MycoBacteria Found In Endometrium Of Uterus. Will This Be A Problem For Pregnancy? Suggest The Treatment?
Question: Non Tuberculosis mycoBacteria found in endometrium of uterus. Is this creates problem in child conceiving.? If yes, what is the right course of treatment ?
Brief Answer:
Please get HSG test for evaluating tube patency
Detailed Answer:
Hi,
Thanks for writing in to us.
As mentioned, you are suffering from Non TB mycobacterium (atypical tuberculosis). This has affected your endometrium of uterus and there is a possibility that your fallopian tubes might also be affected. Failure in pregnancy due to non conceiving depends on the impaired patency of fallopian tubes and any structural abnormality within the uterus.
As a radiologist, I suggest you get a hysterosalpingogram (HSG) test to assess the patency of your fallopian tubes and your uterine cavity.
Regarding treatment of atypical TB:
Medical therapy for non TB mycobacteria involves multiple agents to facilitate clearance of organisms and minimize the emergence of drug resistance.
The cornerstone agents include macrolides, ethambutol, and rifamycin.Three-drug regimens are preferred because of concerns for the development of macrolide resistance. Daily therapy is recommended in most cases. However, for patients who cannot tolerate daily therapy or those who do not require an aggressive treatment strategy, intermittent (3-times-weekly) therapy may be appropriate.
Prolonged durations of therapy are frequently needed and eradication is unlikely. Additionally, treatment regimens are often expensive and are often poorly tolerated because of frequent side effects.
The decision to treat must be balanced between the risk of disease progression and unnecessary exposure to the cost and toxicity of medications. I would like you to consult a pulmonologist (TB specialist) and discuss the treatment from risk benefit point of view.
Hope your query is answered.
Should you have any doubts, please feel free to ask.
Dr.Vivek
Please get HSG test for evaluating tube patency
Detailed Answer:
Hi,
Thanks for writing in to us.
As mentioned, you are suffering from Non TB mycobacterium (atypical tuberculosis). This has affected your endometrium of uterus and there is a possibility that your fallopian tubes might also be affected. Failure in pregnancy due to non conceiving depends on the impaired patency of fallopian tubes and any structural abnormality within the uterus.
As a radiologist, I suggest you get a hysterosalpingogram (HSG) test to assess the patency of your fallopian tubes and your uterine cavity.
Regarding treatment of atypical TB:
Medical therapy for non TB mycobacteria involves multiple agents to facilitate clearance of organisms and minimize the emergence of drug resistance.
The cornerstone agents include macrolides, ethambutol, and rifamycin.Three-drug regimens are preferred because of concerns for the development of macrolide resistance. Daily therapy is recommended in most cases. However, for patients who cannot tolerate daily therapy or those who do not require an aggressive treatment strategy, intermittent (3-times-weekly) therapy may be appropriate.
Prolonged durations of therapy are frequently needed and eradication is unlikely. Additionally, treatment regimens are often expensive and are often poorly tolerated because of frequent side effects.
The decision to treat must be balanced between the risk of disease progression and unnecessary exposure to the cost and toxicity of medications. I would like you to consult a pulmonologist (TB specialist) and discuss the treatment from risk benefit point of view.
Hope your query is answered.
Should you have any doubts, please feel free to ask.
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thanks for the answer but kindly also clarify
"The medicine/treatment suggested by you will still be required to be taken even if HCG test report comes out to be normal i.e fallopian tube is ok/normal."
"The medicine/treatment suggested by you will still be required to be taken even if HCG test report comes out to be normal i.e fallopian tube is ok/normal."
Brief Answer:
Treatment is necessary to control disease process.
Detailed Answer:
Hi,
Thanks for writing in with an update.
I would like to clarify your query.
The HSG being normal signifies that the tubal passages on both sides and the cavity of uterus are normal in patency. This is with respect to any structural problem that is preventing the pregnancy to occur.
The medicine/ treatment is to control the disease process. You never know the extent of damage that can occur if treatment is not taken. The infection can affect the tubes anytime in future if the disease is not controlled.
In other words no one can guarantee that the tubes will be normal in future if proper treatment is not taken. However, treatment in atypical tuberculosis is to be taken under proper medical guidance.
I hope my reply answers your query.
Should you have any doubts, please feel free to ask.
Dr.Vivek
Treatment is necessary to control disease process.
Detailed Answer:
Hi,
Thanks for writing in with an update.
I would like to clarify your query.
The HSG being normal signifies that the tubal passages on both sides and the cavity of uterus are normal in patency. This is with respect to any structural problem that is preventing the pregnancy to occur.
The medicine/ treatment is to control the disease process. You never know the extent of damage that can occur if treatment is not taken. The infection can affect the tubes anytime in future if the disease is not controlled.
In other words no one can guarantee that the tubes will be normal in future if proper treatment is not taken. However, treatment in atypical tuberculosis is to be taken under proper medical guidance.
I hope my reply answers your query.
Should you have any doubts, please feel free to ask.
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Mohammed Kappan
Thanks once again.
But before starting your suggested treatment I want to be doubly sure about the test result of "Non TB mycobacterium".
Is the test process followed by a lab is a "standardised process " being done regularly by medical industry and there is no chance of error??
Do you suggest to get a second test done from another lab?/.
But before starting your suggested treatment I want to be doubly sure about the test result of "Non TB mycobacterium".
Is the test process followed by a lab is a "standardised process " being done regularly by medical industry and there is no chance of error??
Do you suggest to get a second test done from another lab?/.
Brief Answer:
You may repeat test at reputable laboratory
Detailed Answer:
Hi,
Thanks for writing in with an update.
I agree with you when you say that you want to be doubly sure about the test result of "Non TB mycobacterium".
PNB (p-nitrobenzoic acid) test differentiates Mycobacterium Tuberculosis complex (typical) from Atypical Mycobacteria. Helps in the selection of Anti-tubercular drugs. First Line of Anti-tubercular drugs are usually less effective against nontuberculous mycobacteria (NTM), mycobacteria other than tuberculosis (MOTT).
These tests are standardized across the world. However, I would suggest you to get it repeated from a different reputable diagnostic laboratory.
Hope this answers your query.
Wishing you good health.
Dr Vivek
You may repeat test at reputable laboratory
Detailed Answer:
Hi,
Thanks for writing in with an update.
I agree with you when you say that you want to be doubly sure about the test result of "Non TB mycobacterium".
PNB (p-nitrobenzoic acid) test differentiates Mycobacterium Tuberculosis complex (typical) from Atypical Mycobacteria. Helps in the selection of Anti-tubercular drugs. First Line of Anti-tubercular drugs are usually less effective against nontuberculous mycobacteria (NTM), mycobacteria other than tuberculosis (MOTT).
These tests are standardized across the world. However, I would suggest you to get it repeated from a different reputable diagnostic laboratory.
Hope this answers your query.
Wishing you good health.
Dr Vivek
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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