Female genital tuberculosis: the neglected history of a neglected disease and its implications for women’s health

Abstract

Female genital tuberculosis (FGTB) is a rare but significant form of extrapulmonary tuberculosis that is associated with infertility and gynaecological morbidity, particularly in low-income countries. Although this disease is clinically recognised, it has been neglected in the past both in clinical research and in scientific historiography. Our study analyses the evolution of knowledge about FGTB, from the first anatomical-pathological description by Giovanni Battista Morgagni in 1744 to the most recent diagnostic and therapeutic achievements. The historical analysis shows how interest in FGTB has only accelerated since the late 19th century, with important contributions from clinicians such as Ernesto Pestalozza and Arthur M. Sutherland, who promoted a modern approach to diagnosis through histological, bacteriological and radiological investigations. Despite advances in imaging and molecular biology techniques, FGTB still poses a diagnostic challenge due to the non-specific clinical presentation and paucibacillary nature of the disease. Manifestations often lead to late diagnosis, the reason why it represents a paradigmatic example of how a disease can remain largely invisible despite its consequences for individual and public health. We believe that FGTB should be recognised as a neglected infectious disease with clinical, epidemiological and historical implications. Its scientific and historical rediscovery can stimulate further studies and an integrated approach to women’s health.