A CASE OF TUBERCULOUS ANAL FISTULAE COMPLICATED TO PULMONARY TUBERCULOSIS
1994 Volume 69 Issue 11 Pages 689-692
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1994 Volume 69 Issue 11 Pages 689-692
Tuberculous involvement of the anus is very rare at present as the result of BCG-Vaccination and improvement of public health.
We report a juvenile case of tuberculous anal fistulae complicated to pulmonary tuberculosis. A 22-year-old male was admitted with symptoms of 13 month- history of intermittent anal pain, low grade fever and cough. Chest X-ray showed bilateral middlezone infiltrates with cavitation. Perianal inspection revealed a large ulcer with purulent exudate and a few fistulae. Sputum smears showed acidfast bacilli. A biopsied specimen of perianal fistulae showed granulomatous lesions with central necrosis, epitheloid cells and multi-nucleated giant cells. With three-drug antituberculous regimen, his symptoms resolved, radiographic infiltrates improved, and the perianal fistulae were cured.
It was speculated that the tuberculous anal fistulae in this case were caused by the dissemination from the pulmonary focus via the hematogeneous and lymphogeneous routes, because any tuberculous lesion was not detected in the gastrointestinal tract and rectum.
