Genital Tuberculosis in a Nigerian Woman with Primary Infertility

We present a 30-year-old nullipara with a two-year history of inability to conceive and a 30-month history of recurrent lower abdominal pain. A transvaginal ultrasound scan showed a right complex adnexal mass measuring 70 cm × 65 cm; tumor makers were essentially normal aside marginally elevated CA-125. She subsequently had exploratory laparotomy with right salpingo-oophorectomy, and a histopathology examination of the specimen revealed caseous necrosis, granuloma formation with a rim of the Langhans giant cells within the wall of the fallopian tube. Serum tuberculosis (TB) QuantiFERON was also positive for Mycobacterium tuberculosis. She is currently on anti-Koch’s and is responding to treatment. This case report aims to highlight the need for exploring other causes of chronic pelvic pain and primary infertility when evaluating women with similar history in our environment, especially in TB endemic areas.