Kamla, a 30 yrs old lady examined for infertility by hysterosalpingography, reveals 'Bead-like' fallopian tube and clubbing of ampulla. Most likely cause is:

Ans. is d, i.e. Mycobacterium tuberculosisRef: Shaw 15th/ed, pl57The following findings on hysterosalpingogram strongly suggest tubercular salpingitis:* A rigid nonperistaltic pipe like tube, called lead pipe appearanceQ* Beading and variation in filling densityQ* Calcification of the tubeQ* Cornual blockQ* A jagged fluffiness of the tubal outlineQ* Vascular or lymphatic intravasation of the dyeQ* Tobacco-pouch appearance seen on naked eye examination.Also Note:* In a proven case of genital tuberculosis, hysterosalpingography is contraindicated as it may spread the infection.* In TB Endometritis on HSG: The uterine cavity is shrivelled and obliterated by adhesions giving honeycomb appearance.* On USG: Incomplete septation of the tubal wall "Cogwheel sign" is a marker for acute disease. Thin wall and beaded string appearance is a marker for chronic disease.