Tubercular endometritis: a rare condition reliably detectable with fluid hysteroscopy

A rare case of tubercular endometritis occurred in a 63-year-old nullipara, postmenopausal woman, who was referred to our institute with vaginal bleeding and hyperechoic endometrial lesions at transvaginal sonography. At hysteroscopy the endometrial mucosa was lightly hyperemic and almost completely covered by multiple whitish and irregular deposits resulting in a "geographic map-like" aspect of the endometrial surface. The deposits had irregular borders and surface. Their size showed a wide range from less than 1mm to several millimeters. When touched by the tip of hysteroscope they did not bleed and peeled off easily. Diagnosis was performed with histologic examination and by using polymerase chain reaction. At follow-up hysteroscopy 6 months after antitubercular therapy, the endometrial mucosa appeared normal.