A case of infertility diagnosed with tuberculous endometritis

Abstract

A 30-year-old woman presented with infertility and irregular menstruation. Physical examination revealed obesity and slightly pale conjunctivae. Transvaginal ultrasound revealed polycystic ovary, bilateral hydrosalpinx, and endometrial thickening. Magnetic resonance imaging of the pelvis showed several large cystic lesions and elongated fallopian tubes. An endometrial biopsy was performed to investigate the endometrial thickening. Pathological findings included small non-caseating epithelioid cell granulomas with scattered plasma cell infiltration. The microbiological analysis of the endometrial biopsy sample showed a negative result for Ziehl–Neelsen staining; however, after four weeks, the Mycobacterium culture was positive for Mycobacterium tuberculosis. Thus, a definitive diagnosis of tuberculous endometritis was made. The patient was effectively treated with the standard treatment comprising isoniazid, rifampicin, ethambutol, and pyrazinamide for 6 months.

Keywords

• Tuberculous endometritis
• Infertility
• Irregular menstruation
• Small non-caseating epithelioid cell granulomas