Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2015; 3(9): 848-852
Published online Sep 16, 2015. doi: 10.12998/wjcc.v3.i9.848
Perianal tuberculosis: A case report and review of the literature
Sayaka Tago, Yuji Hirai, Yusuke Ainoda, Takahiro Fujita, Mikio Takamori, Ken Kikuchi
Sayaka Tago, Yuji Hirai, Yusuke Ainoda, Takahiro Fujita, Ken Kikuchi, Department of Infectious Diseases, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo 162-8666, Japan
Mikio Takamori, Department of Pulmonary Medicine, Tokyo Metropolitan Tama Medical Center, Fuchu-shi, Tokyo 183-8524, Japan
Author contributions: Takaomri M managed patient care; Hirai Y and Kikuchi K reviewed the article; Ainoda Y and Fujita T provided valuable advice on the article; Tago S designed the study, conducted the patients, and wrote the manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed consent prior to study enrollment.
Conflict-of-interest statement: No conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sayaka Tago, MD, Department of Infectious Diseases, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. asahata.sayaka@twmu.ac.jp
Telephone: +81-3-33538112 Fax: +81-3-33588995
Received: December 6, 2014
Peer-review started: December 6, 2014
First decision: February 13, 2015
Revised: June 17, 2015
Accepted: July 3, 2015
Article in press: July 6, 2015
Published online: September 16, 2015
Processing time: 283 Days and 3.8 Hours
Abstract

Tuberculosis (TB) is still a major health problem worldwide. We present a rare case of an immuno-competent patient with perianal TB. A 38-year-old man visited a clinic with pain, swelling, and redness in the perineum. He had been persistently coughing for the past 6 mo. The abscess had formed a fistula to the perianal region, indicating perianal abscess. Mycobacterium tuberculosis was found in sputum and perianal abscess. Surgical drainage was performed, and oral anti-tuberculous drugs were administered for 6 mo. The patient’s clinical course was favorable. On review of the literature on 58 cases of perianal TB, we found that the duration of persistent perianal lesion was much longer in patients without active pulmonary TB (APTB) than in those with APTB (66.4 mo vs 8.3 mo; confidence interval, 0.0760-0.9620, P = 0.0380). Thus, in cases of non-healing or recurrent perianal lesions, TB should be considered.

Keywords: Tuberculosis; Abscess; Ulcer; Hemorrhoids; Fistula

Core tip: We present a case of an immuno-competent patient with perianal tuberculosis (TB) and active pulmonary TB (APTB). In our literature review of 58 cases of perianal TB, we found that the duration of persistent perianal lesions was much longer in patients without APTB than in those with APTB (66.4 mo vs 8.3 mo; confidence interval, 0.0760-0.9620; P = 0.0380). In cases of non-healing or recurrent perianal lesions, the diagnosis of TB should be considered and culture for Mycobacterium tuberculosis and histologic examination should be conducted.