PLE-4440

What is the diagnosis for a 28-year-old sexually active female, nulligravid, who presented with fever, nausea, vomiting, and severe pelvic pain? The pelvic exam was positive for adnexal tenderness. She was diagnosed with PID and managed accordingly. Despite several treatment regimens, her symptoms continue to recur, and she also experiences infertility and abnormal uterine bleeding. A laparoscopy was performed, revealing a tobacco pouch appearance of the oviducts.