Abstract
Childhood and adolescent TB is a silent epidemic. The occurrence of genital tuberculosis (TB) in adolescent girls is rare. This condition is easily misdiagnosed owing to its non-specific clinical presentation that mimics different gynecological or non-gynecological pathologies. We present an unusual case of genital TB in an 11-year-old girl with an acute abdomen, where the clinical and radiological findings contributed to the diagnostic confusion with hematometra. This case highlights a rare case of genital TB in a teenage girl, and its clinical and diagnostic complexities, emphasizing the importance of considering TB as a differential in all cases of pelvic masses in high-burden settings. This case also exemplifies the need for a multidisciplinary approach to facilitate timely diagnosis and treatment to prevent the devastating effects of genital TB on the reproductive health of young girls.