Perianal Tuberculosis in an Immunocompetent Patient: Exploring the Uncommon Manifestation

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 patient

Consent 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

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