A case report: incidental diagnosis of endometrial tuberculosis in cases of abnormal uterine bleeding


  • Induja B. V. Department of Obstetrics and Gynecology, D. Y. Patil Hospital and Research centre, Kolhapur, Maharashtra, India
  • Vasudha Sawant Department of Obstetrics and Gynecology, D. Y. Patil Hospital and Research centre, Kolhapur, Maharashtra, India
  • Mohan Potdar Department of Pulmonology, D. Y. Patil Hospital and Research centre, Kolhapur, Maharashtra, India
  • Rupali Mahesh Dalvi Department NTEP, D. Y. Patil Hospital and Research centre, Kolhapur, Maharashtra, India




AUB, Endometrial tuberculosis, CBNAAT-TB, Dysmenorrhea, Adenomyosis


Abnormal uterine bleeding (AUB), including heavy menstrual bleeding (HMB), levy a massive burden on society. Here, we discuss about two patients who came to OPD with AUB symptoms for evaluation, but incidentally diagnosed with endometrial tuberculosis. In Case 1, 45-year-old female came with complains of heavy menstrual bleeding for 6 months for 6 months. USG showed adenomyosis. Patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. But on day 7 she developed serous blood-tinged discharge per vaginum. Incidentally, patient endometrial CBNAAT report came positive for MTB, with no resistance to rifampicin. Patient was started on anti-tubercular treatment for 6 months. In Case 2, 43-year-old female came with complaints of HMB with pain abdomen and irregular menses for 3 years. USG shows early changes of Adenomyosis. Patient underwent therapeutic curettage with MIRENA insertion. Endometrial CBNAAT was negative and liquid culture (LJ) was MDR positive. Sensitivity report s/o of isoniazid and rifampicin resistant. Patient was advised monthly close follow up as symptoms were under control. When a routine screening for FGTB by CBNAAT is done for cases of AUB, there are high chances of reporting more cases in a developing nation like India. Hence sending endometrial samples for TB screening in AUB cases can be useful in finding out more cases of genital TB, where their symptoms can be related to TB infection rather than searching for a structural cause that may be is not the cause for the severe symptoms. Due to which mismanagement or unnecessary surgical interventions can be avoided.


Davis E, Sparzak PB. Abnormal Uterine Bleeding. 2022 Sep 9. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2022;30422508.

Marnach ML, Laughlin-Tommaso SK. Evaluation and Management of Abnormal Uterine Bleeding. Mayo Clin Proc. 2019;94(2):326-35.

Female genital tuberculosis: Revisited; Indian J Med Res. 2018;148:71-83.

Lasmar RB, Bernardo PL. The role of leiomyomas in the genesis of abnormal uterine bleeding (AUB). Best Pract Res Clin Obstetr Gynaecol. 2017;40:82-8.

Tzelios C, Neuhausser WM, Ryley D, Vo N, Hurtado RM, Nathavitharana RR. Female Genital Tuberculosis. Open Forum Infect Dis. 2022;9(11):ofac543.

Kesharwani H, Mohammad S, Pathak P. Tuberculosis in the Female Genital Tract. Cureus. 2022;14(9):e28708.

Papakonstantinou E, Adonakis G. Management of pre-, peri-, and post-menopausal abnormal uterine bleeding: When to perform endometrial sampling? Int J Gynaecol Obstet. 2022;158(2):252-9.

TB Statistics India. 2022. Available at: https://tbfacts.org/tb-statistics-india/. Accessed on 1, August, 2023.

Global Tuberculosis Report 2021. World Health Organization, Geneva, Switzerland. 2021. https://www.who.int/publications/i/item/9789240037021. Accessed on 1, August, 2023.

Sharma JB, Sharma E, Sharma S, Dharmendra S: Recent advances in diagnosis and management of female genital tuberculosis. J Obstet Gynaecol India. 2021;71:476-87.






Case Reports