Tuberculous abscess of the left gluteal region and iliac fossa following transvaginal ultrasound-guided oocyte retrieval: a case report

Osteoarticular and soft-tissue tuberculosis is relatively uncommon in clinical practice and is often characterized by insidious onset and non-specific symptoms. Its manifestations may mimic those of degenerative disorders, frequently leading to delayed or incorrect diagnosis. These challenges are further amplified when the infection occurs at rare, procedure-related sites, which are easily overlooked. We report the case of a 31-year-old woman who developed persistent pain in the left gluteal and lower abdominal regions after ultrasound-guided transvaginal ovarian needle drilling (UTND) performed in May 2023. The patient subsequently experienced pregnancy loss but did not present with systemic symptoms such as fever or chills. She was initially misdiagnosed with lumbar disc herniation at an outside hospital, and conservative management failed to relieve her symptoms. Upon admission to our institution, she underwent surgical debridement of lesions in the left gluteal area and iliac fossa. Histopathological examination of intraoperative abscess specimens confirmed Mycobacterium tuberculosis infection, and standardized anti-tuberculosis therapy was administered postoperatively, and no recurrence has been observed during follow-up. This case highlights the need for heightened clinical vigilance regarding tuberculosis infections at rare, procedure-related anatomical sites. For patients presenting with similar non-specific symptoms, tuberculosis should be considered in the differential diagnosis to ensure timely identification and appropriate treatment, thereby preventing disease progression and serious complications.