A 28-year-old woman with primary infertility has a hysterosalpingogram showing a 'golf-club deformity' of the fallopian tube, beaded appearance of the tubes, and a small irregular uterine cavity. Endometrial biopsy shows granulomas with Langhans giant cells. What is the recommended treatment duration?
- A 2HRZE + 4HR (6 months, standard short-course)
- B 2HRZE + 4HR then assess for surgery
- C 2HRZE + 7HR (9 months total) ✓
- D 12 months of HRZE
Correct answer: C. 2HRZE + 7HR (9 months total)
Explanation
Genital tuberculosis (endometrial TB with tubal involvement) is an extrapulmonary TB. RNTCP/NTEP recommends 9 months of anti-TB treatment for genital TB: 2 months of intensive phase (HRZE) followed by 7 months of continuation phase (HR), totalling 9 months — longer than pulmonary TB (6 months), reflecting the poor vascularity and thick fibrous caseous lesions in genital TB. Surgery (salpingectomy or reconstructive) is considered only after completion of treatment for residual disease or infertility management.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.