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DOI: 10.1055/s-0044-1787286
Perianal Tuberculosis in an Immunocompetent Patient: Exploring the Uncommon Manifestation
Fundings No funds, grants, or other support was received.

Abstract
As it is an infrequent etiology, the diagnosis of perianal tuberculosis is challenging, especially in the absence of a pulmonary focus. TB should be considered in the differential diagnosis of perianal ulcers, fistulas, abscesses, mainly in non-healing and recurrent anal lesions. Treatment with anti-TB agents can provide complete recovery. Furthermore, these lesions are often diagnosed later after complete histopathological and mycobacterial results, where the benefit of avoiding morbid multiple surgeries by effective anti-TB treatment is lost.
We reported a rare case of an immuno-competent patient with perianal TB, which was the first manifestation of the disease. A fit-and-well man in his 20s presented a large perianal abscess. Unexpectedly, his chest X-ray showed a rounded hyper-transparency in the left lung. The abscess was drained. Posterior investigation with culture analysis from pus swabs and sputum revealed the presence of Mycobacterium tuberculosis complex infection. After completing the 6 months of oral administration of anti-TB drugs, the patient was asymptomatic.
By highlighting this unusual manifestation, we aim to improve clinicians' awareness of perianal TB, facilitating early recognition and appropriate management.
Keywords
extrapulmonary tuberculosis - mycobacterium tuberculosis complex infection - perianal tuberculosis - inflammatory bowel disease - tuberculosis-associated immunocompetent patientConsent to Participate
The patient consented to this case report.
Written Consent for Publication
The first author obtains the patient's written consent for publication.
Authors' Contributions
AF is responsible conception and design of the article, for writing the manuscript (and revision), and received informed consent from the patient. HP and BC are responsible for critically revising the article. JF and JE are responsible for the surgical care of the patient and critical revision of the article. BP, SV, and MO are responsible for the surgical department, and they critically revised the article.
Ethics Approval
Not applicable
Availability of Data and Material (Data Transparency)
The authors confirm that the data supporting the findings of this study are available within the article.
Code Availability (Software Application or Custom Code)
Not applicable
Publication History
Received: 10 April 2023
Accepted: 07 February 2024
Article published online:
06 June 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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