Background: A unique case of pelvic tuberculosis in a patient with primary infertility and findings on laparoscopy and hysterosalpingogram are presented. Case: A 33-year-old nulliparous female originally from China presented to an infertility specialist with primary infertility. Hysterosalpingogram revealed left tubal occlusion and right hydrosalpinx. Extensive pelvic disease was visualized during laparoscopy, which included adhesions and multiple implants on the peritoneum and pelvic organs. Pathology testing revealed extensive transmural necrotizing granulomas consistent with tuberculosis salpingitis. Results: Although acid-fast cultures were negative, a decision was made to proceed with treatment, because of the strong suspicion of disease. Conclusions: Gynecologists should be knowledgeable about the presentation of pelvic tuberculosis at the time of hysterosalpingogram and laparoscopy. Patients with risk factors should be referred to an infectious-disease specialist immediately. (J GYNECOL SURG 30:173)
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