HYSTEROSCOPY MARKERS AS A DIAGNOSTIC TOOL FOR TUBERCULAR ENDOMETRITIS- A CASE REPORT FROM MAHARASHTRA, INDIA

Abstract

Tuberculosis (TB) is a public health concern for many high burden countries and especially for India which carries a fourth of global burden of TB. The diagnosis of tubercular endometritis is challenging. In our report, we present a case of a 27-year-old woman with infertility and experienced pain in abdomen. Hysteroscopy revealed a narrowed internal cervical ostium, a pale, cloudy endometrium with absence of glands, obliterated ostia, and ostial adhesions. Hysteroscopic multiple directed endometrial biopsies were taken and histopathology, TB-Polymerase Chain reaction, and Cartridge based Nucleic Acid Amplification Test (CBNAAT) confirmed tuberculosis. Our case report suggests that hysteroscopic directed biopsies are superior to blind curettage.  Visualization of early hysteroscopic markers can prevent irreversible damage to the endometrium and thereby improve reproductive performance. Training clinicians in hysteroscopic markers and educating women in India can further help to diagnose and treat this type of TB at an early stage.