TUBERCULOUS ANAL FISTULA: A CASE REPORT
S. Riffi Temsamani*, L. El Aoufi, K. Attaqui, A. Zaoui, A. Akjay, H. Ouaya, H. Meyiz and I. Mellouki
ABSTRACT
Ano-perineal tuberculosis is a rare and often underdiagnosed form of extrapulmonary tuberculosis, representing less than 0.7% of gastrointestinal tuberculosis cases. We report the case of a 55-year-old woman with a history of type II diabetes and recently initiated anti-tuberculous therapy for sacroiliitis, who presented with proctalgia and purulent anal discharge. Clinical examination revealed a fistulous opening, and histopathological analysis confirmed granulomatous inflammation suggestive of a tuberculous origin. The patient showed complete healing after a nine-month course of anti-tuberculosis treatment. This case highlights the diagnostic challenges posed by ano-perineal tuberculosis due to its nonspecific clinical features, often mimicking Crohn’s disease or cryptoglandular fistulas. Early recognition, particularly in endemic regions, is crucial to avoid complications such as recurrence or anal incontinence. Diagnosis relies on histological and microbiological confirmation, and treatment is primarily medical, with surgery reserved for drainage of complex lesions.
Keywords: Anal fistula, Ano-peritoneal tuberculosis, Extra pulmonary tuberculosis, Morocco.
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