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A 60-year-old postmenopausal woman presented with the complaint of generalized fatigue
and body ache since 5 months. She had attained menopause at the age of 55 years. She
denied any history of vaginal discharge or postmenopausal bleeding, and was prescribed
calcium and multivitamins while being referred from one general practitioner to another.
She was finally referred to the gynecology clinic for suspected menopausal symptoms.
We did a speculum examination, which showed the cervix and vagina replaced by a hard
matted mass (Figure). There was no bleeding, discharge, or tenderness. Biopsy from this mass showed granulomatous
inflammation, positive for acid-fast bacilli. We started her on antitubercular therapy
for 6 months, after which her symptoms resolved.
FigureHard matted mass discovered per speculum examination
