examination were normal, hemoglobin (Hb) was 6.2 gm% and TLC was normal. The thyroid proÞ le and reproductive hormonal proÞ le, including prolactin levels, were normal, with a normal chest X-ray. Mantoux test was positive at 25×25 cm and ESR was raised-48 mm in Þ rst hour. IgG ELISA for TB (Tuberculosis) was high positive, i.e., greater than 400 U/ml (Immuno Vision's M. tuberculosis IgG Avidity ELISA test kit [USA], supplied by Amar Diagnostics, Mumbai, India). Sputum and urine examination did not reveal any AAFB. She was vaccinated with BCG at birth.Since invasive procedures could not be undertaken in this particular patient, her menstrual blood was sent for AFB examination. Mycobacterial culture facilities were not available and hence, not done. The sample was homogenized, centrifuged at 3000 rpm for 15 minutes and smears were made from the deposit. After dehemoglobinizing the smear, it was stained by Zeihl Neelsen (ZN) stain, using 3% acid alcohol as a decolorizer. On examination under oil immersion, straight to slightly curved, beaded, acid and alcohol fast bacilli (AAFB), with morphology suggestive of Mycobacterium tuberculosis were seen (Fig. 1). Two consecutive samples in the same menstrual cycle were also positive for AAFB.The patient was diagnosed as a case of genital tuberculosis and anti-tubercular therapy (ATT-category I) was started, according to RNTCP guidelines.[1] After one month of treatment, when patient came for follow-up, she HIV-induced immunosuppression paves the way for several infections, tuberculosis being very common in our country. Female genital tuberculosis (FGTB), presenting as menstrual irregularities, is a diagnostic challenge in an adolescent female when these may be considered normal. The present case is of a young female who presented with menstrual irregularities, diagnosed subsequently as a case of genital tuberculosis. Microbiological relapse after anti-tubercular treatment of six months caused suspicion of a co-existing immunodeÞ ciency and investigations revealed HIV co-infection; thus emphasizing the need of HIV testing in all patients of tuberculosis for timely diagnosis and treatment support thereafter.