Anoperineal Tuberculosis

Abstract

Tuberculosis should be suspected in all recurrent fistulas. Histologic examination of the excised tissue and a lung x-ray should be performed to avoid delay in diagnosing an easily curable disease.

The Treatment of Anal Fistula: ACPGBI Position Statement

“…Treatment involves drainage of perianal sepsis and appropriate medical antituberculosis treatment [299,300] (level IV, grade GP).…”

Anal fistula: an unusual presentation of tuberculosis in a migrant health care professional

“…The microbiology of chronic and non-Crohn's anal fistulae in 25 consecutive anal fistulae was studied prospectively in a London hospital, and only one patient had Mycobacterium tuberculosis grown [4]. Sultan et al [5] reported a case series of seven patients managed in a Parisian proctology unit over a 17-year period for anorectal tuberculosis. In their series, a typical case of anorectal tuberculosis would be an immigrant aged [50 years with poor socio-economic background.…”

Perianal Tuberculosis: A Case Report and a Review of the Literature

“…Sultan et al documented data of seven cases of anoperineal tuberculosis observed between 1982 and 1999. An association with pulmonary tuberculosis was found in each case, as well [9]. …”

“…Differentiating the condition from Crohn's disease with anoperineal localization can be difficult if there is no caseation or direct evidence of acid fast bacilli [19]. Bacteriological analysis is done by identification of Koch's bacilli by direct examination (Ziehle-Neelsen stain) and culture [9]. The diagnosis is supported by the clinical response to an antitubercular therapy [20].…”

“…Surgical procedures are needed if there is a fistula or abscess [9]. The ulcerative lesions of the anus associated with tuberculosis regress in few weeks following the treatment.…”