Utility of reverse transcriptase PCR and DNA-PCR in the diagnosis of female genital tuberculosis

This study was designed to test the utility of mRNA-based RT-PCR to detect viable bacilli, indicating active tubercular involvement, and DNA-PCR to detect present or past infection in the diagnosis of active female genital tuberculosis (TB) infection. A total of 200 subjects with complaints of infertility were enrolled in the study. Multiple sampling was done. One hundred and forty-three endometrial aspirate (EA), 94 peritoneal fluid/peritoneal washing (PF/PW) and six cornual biopsy (CB) specimens were collected for diagnosis using microscopy, culture, RT-PCR and DNA-PCR and results were compared with laparoscopic findings. RT-PCR and culture were concordant [positive in four (2.8%) EA specimens] signalling sampling from the site of active infection. Smear microscopy showed a poor detection rate while DNA-PCR showed high positivity. Sixty-one (44.85%) EA specimens, nine (9.57%) PF/PW specimens and two (33.33%) CB specimens were positive by DNA-PCR. Genital TB causing infertility (localized or secondary to TB elsewhere) can be picked up early by DNA-PCR, when it can be completely cured prior to the appearance of florid disease.