Diagnosis of Genital Tuberculosis Unveiled by Utero-Cutaneous Fistula and Superimposed MRSA Infection: A Case Report

Mishu Mangla, Naina Kumar, Abhimanyu Sharma, Annapurna Srirambhatla, Nireesha Bukke, Sunil Kumar Demappa Chavan, Subhrajyoti Roy
Infectious disorders drug targets · 2025 · vol. 25(6) , pp. e18715265350486 · doi:10.2174/0118715265350486250102101626 · PMID:39901676
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-12 ⓘ

This case report details a 35-year-old female with a utero-cutaneous fistula and tubo-ovarian abscess caused by superimposed MRSA infection on genital tuberculosis, diagnosed via histopathology.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text ⓘ

This paper reports a single case of a 35-year-old woman with severe pain and menstrual blood discharge from a transverse suprapubic caesarean scar nine months after surgery, ultimately found to have both MRSA chronic infection and genital tuberculosis. Diagnosis was confirmed after histopathologic examination of the fistulous tract and a tubo-ovarian abscess, which revealed the combination rather than being established through initial clinical evaluation alone. The authors present it as an example of a utero-cutaneous fistula associated with superimposed MRSA infection and concurrent genital tuberculosis, emphasizing the need for thorough multidisciplinary evaluation, though as a case report it provides no generalizable incidence or comparative effectiveness data. Relevance to endometriosis: the paper’s keywords list “scar endometriosis” as a differential/associated consideration in the context of post-surgical scar complications, though the final diagnosis was MRSA genital tuberculosis with a utero-cutaneous fistula.

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Abstract

BACKGROUND: Both tuberculosis and Methicillin-Resistant Staphylococcus aureus (MRSA) are known to be notorious for causing fistulas due to their characteristics of persistent, difficult-to-treat infections that lead to chronic inflammation, abscess formation, and tissue necrosis. There are several case reports highlighting the invasiveness and potential for fistula formation associated with both tuberculosis and MRSA infections independently, but to the best of our knowledge, this is the first case of a utero-cutaneous fistula caused by chronic infection due to MRSA, superadded on genital tuberculosis. CASE PRESENTATION: A 35-year-old female, P3L3, visited the gynaecology outpatient department nine months after her last caesarean section with the complaint of severe pain and blood discharge from the transverse supra-pubic scar during menstruation. On evaluation, she was found to be chronically infected with MRSA and have genital tuberculosis only after histopathologic examination of the fistulous tract and tubo-ovarian abscess. CONCLUSION: This case highlights the importance of considering genital tuberculosis in patients with atypical or refractory post-surgical complications and emphasizes the need for a thorough and multidisciplinary approach to its management.
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Abstract

Background: Both tuberculosis and Methicillin-Resistant Staphylococcus aureus (MRSA) are known to be notorious for causing fistulas due to their characteristics of persistent, difficult-to-treat infections that lead to chronic inflammation, abscess formation, and tissue necrosis. There are several case reports highlighting the invasiveness and potential for fistula formation associated with both tuberculosis and MRSA infections independently, but to the best of our knowledge, this is the first case of a utero-cutaneous fistula caused by chronic infection due to MRSA, superadded on genital tuberculosis. Case Presentation: A 35-year-old female, P3L3, visited the gynaecology outpatient department nine months after her last caesarean section with the complaint of severe pain and blood discharge from the transverse supra-pubic scar during menstruation. On evaluation, she was found to be chronically infected with MRSA and have genital tuberculosis only after histopathologic examination of the fistulous tract and tubo-ovarian abscess.

Conclusion

This case highlights the importance of considering genital tuberculosis in patients with atypical or refractory post-surgical complications and emphasizes the need for a thorough and multidisciplinary approach to its management.

Keywords

Uterocutaneous fistula, genital tuberculosis, methicillin-resistant Staphylococcus aureus, scar endometriosis, complication of caesarean section, tubo-ovarian abscess. [http://dx.doi.org/10.1136/pgmj.69.816.822] [PMID: 8290420] [http://dx.doi.org/10.4274/tjod.galenos.2019.29560] [PMID: 31360589] [http://dx.doi.org/10.1016/j.ejrex.2008.05.009] [http://dx.doi.org/10.5858/2010-0144-CRR1] [PMID: 21810000] [http://dx.doi.org/10.1097/MAJ.0b013e31823e612a] [PMID: 22227512] [http://dx.doi.org/10.1136/bcr-2021-242907] [PMID: 34479881] [http://dx.doi.org/10.1186/s12879-023-08550-z] [PMID: 37641023] [PMID: 26989289] [http://dx.doi.org/10.5812/ircmj.41813] [http://dx.doi.org/10.1089/gyn.2010.0020] [http://dx.doi.org/10.1136/bcr-2018-224738] [PMID: 29884667] [http://dx.doi.org/10.1097/01.AOG.0000188067.74163.40] [PMID: 17018482] [http://dx.doi.org/10.1007/s00404-008-0683-7] [PMID: 18506462] [http://dx.doi.org/10.5348/ijcri-201709-CS-10088] [http://dx.doi.org/10.1016/j.ejogrb.2006.04.041] [PMID: 16806645] [http://dx.doi.org/10.1155/2022/8078639] [PMID: 36016849] [http://dx.doi.org/10.4103/ijmr.IJMR_648_18] [PMID: 30964083] [http://dx.doi.org/10.1016/j.crwh.2018.02.001] [PMID: 29594005] [http://dx.doi.org/10.1111/j.1479-828X.1995.tb02002.x] [PMID: 8546664] [http://dx.doi.org/10.59284/jgpeman57] [http://dx.doi.org/10.1007/s13224-018-1197-2] [PMID: 31391749] [http://dx.doi.org/10.21276/aimdr.2017.3.6.OG5] [http://dx.doi.org/10.1016/j.athoracsur.2015.03.093] [PMID: 26140804] [http://dx.doi.org/10.1186/1758-3284-2-14] [PMID: 20584326] [http://dx.doi.org/10.1155/2017/1492910] [http://dx.doi.org/10.1016/j.jmig.2011.10.010] [PMID: 22381970] [http://dx.doi.org/10.1016/S1473-3099(15)00238-8] [PMID: 26631833] [http://dx.doi.org/10.1017/S0950268817000012] [PMID: 28219463]

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Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula Cutaneous Fistula

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