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Perianal Tuberculosis in an Immunocompetent Patient: Exploring the Uncommon Manifestation

2024; Thieme Medical Publishers (Germany); Volume: 44; Issue: 02 Linguagem: Inglês

10.1055/s-0044-1787286

2317-6423

Ana Rita Ferreira, Hugo Pereira, Bárbara Castro, Joana Ferreira, Joana Esteves, Bela Pereira, Sílvio Vale, Manuel Oliveira,

Diagnosis and treatment of tuberculosis

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.