Perianal tuberculous ulcer with active pulmonary, intestinal and orificial tuberculosis: A case report

Abstract

BACKGROUND

Orificial tuberculosis is a rare type of tuberculosis, which is easy to be misdiagnosed, and can cause great damage to the perianal skin and mucosa. Early diagnosis can avoid further erosion of the perianal muscle tissue by tuberculosis bacteria.

CASE SUMMARY

Here, we report a case of disseminated tuberculosis in a 62-year-old male patient with a perianal tuberculous ulcer and active pulmonary tuberculosis, intestinal tuberculosis and orificial tuberculosis. This is an extremely rare case of cutaneous tuberculosis of the anus, which was misdiagnosed for nearly a year. The patient received conventional treatment in other medical institutions, but specific treatment was delayed. Ultimately, proper diagnosis and treatment with standard anti-tuberculosis drugs for one year led to complete cure.

CONCLUSION

For skin ulcers that do not heal with repeated conventional treatments, consider ulcers caused by rare bacteria, such as Mycobacterium tuberculosis.

Keywords: Pulmonary tuberculosis; Orificial tuberculosis; Perianal tuberculous ulcer; Mycobacterium tuberculosis; Case report

Core Tip: The occurrence of perianal ulcer is generally considered bacterial or fungal infection. If long-term treatment is ineffective, rare infection types such as tuberculosis infection should be considered. Early diagnosis can avoid the erosion of perianal skin, mucous membranes and muscles. We report a case of disseminated tuberculosis in a 62-year-old male patient with a perianal tuberculous ulcer and active pulmonary, intestinal and orificial tuberculosis. A computed tomography scan revealed active tuberculosis, whereas a colonoscopy showed lesions in the ileum, suggestive of intestinal tuberculosis. The pathology report was consistent with granulomatous inflammation, and the histological analysis of the ulcer and perianal granulation tissue revealed granulomatous lesions of unknown nature. The T-spot test was positive. The patient was treated and cured with standard anti-tuberculosis drugs, whose regimen we describe in this case study.