A case report of genital tuberculosis resulting in Asherman’s syndrome and infertility

Abstract

Background: Tuberculosis can affect any organ in the body. Genital tuberculosis is generally rare. The relative rarity and lack of cardinal symptoms of female genital tuberculosis results in diagnosis delays. 
Case detail: A 26-year-old primipara mother presented to our hospital with amenorrhea and infertility. With the clinical impression of Asherman’s syndrome, Dilatation and curettage (D and C) was done and tissue was sampled for histopathology. The sampled endometrial tissue showed extensive necrosis, nodular aggregates of epithelioid granulomas, and Langhan’s type giant cells which are prototype of mycobacterium tuberculosis.  She was subsequently put on anti-tubercular medications and copper intrauterine device (ParaGard) to avoid adhesion reformation. Three months into her treatment, she started to have monthly vaginal spotting heralding the resumption of menses. Six months later she begun to have a regular menses. 
Conclusion: Genital tuberculosis remains a significant cause of infertility in developing countries. Physicians should maintain high index of suspicion for genital tuberculosis in developing countries with high tuberculosis burden.