Tubercle bacilli also may reach the bloodstream and thus the genital tract from extrapulmonary and chronic pulmonary lesions. The fallopian tube forms a most favorable nidus for tubercle bacilli, with the earliest lesion found in the mucosa. The tendency of the tubercle bacillus to affect bilateral organs results in both tubes being involved in the tuberculous process. There is almost uniform initial pelvic involvement of the tubes, with subsequent dissemination to other genital organs and the peritoneum. Tuberculous peritonitis is commonly seen with genital tract involvement and may also be associated with rupture of a caseous abdominal lymph node or, less frequently, with spread from an intestinal focu