Case 4: A 44-yr-old gravidity 5, primiparous female with four abortions in the first trimester and with a post-neonatal death of her child presented with irregular menstrual bleeding and abdominal pain. There was no history of contact with a TB patient. Pelvic examination revealed a pelvic mass of 10 cm and abdominal fluid collection. CA125 was 1000 mg/dL, and CA19-9 was 139 mg/dL. Endometrial biopsy was reported to be granulomatous endometritis. Four liters of serohemorrhagic fluid and miliary spread of small foci of nodules in all peritoneal surfaces including bilateral tubal structures and ovaries were encountered in explorative laparotomy. 
Examination of frozen sections demonstrated necrotizing granulomatous inflammation. Samplings of the peritoneal lesions and ascites were performed for microbiological evaluation. After homogenization and decontamination procedure, no AFB was seen from peritoneal fluid. In peritoneal fluid culture, both LJ and MGIT mediums were positive. The strain was identified as MTC. Anti-TB susceptibility was performed and the strain was sensitive to all first-line anti-TB drugs.