Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Aug 28, 2024; 16(8): 356-361
Published online Aug 28, 2024. doi: 10.4329/wjr.v16.i8.356
Perianal tuberculous ulcer with active pulmonary, intestinal and orificial tuberculosis: A case report
Bao Yuan, Chao-Qun Ma
Bao Yuan, Department of General Surgery, Jiangyin Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi 214400, Jiangsu Province, China
Chao-Qun Ma, Department of General Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Co-corresponding authors: Bao Yuan and Chao-Qun Ma.
Author contributions: Yuan B contributed to manuscript writing and editing, and data collection; Ma CQ contributed to directed the writing and supervision; and all authors have read and approved the final manuscript. Yuan B and Ma CQ with the equal contribution to this manuscript. Yuan B is responsible for all contact and correspondence with the journal.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bao Yuan, Doctor, Department of General Surgery, Jiangyin Hospital Affiliated to Nanjing University of Chinese Medicine, No. 130 Renming Road, Wuxi 214400, Jiangsu Province, China. doctoryuan1985@gmail.com
Received: April 9, 2024
Revised: June 20, 2024
Accepted: July 18, 2024
Published online: August 28, 2024
Processing time: 141 Days and 3.1 Hours
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.