FISTULATING PERIANAL ABSCESS - A RARE MAN IFESTATION OF TUBERCULOSIS

The 75 year old patient suffered from perianal pruritus and weeping. H e also had a temporary productive cough and a weight reduction of 9 kg during the last six months. The diagnosis of an anorectal tuberculosi s based on the histological proof of caseating granuloma with acid fas t bacteriae from an anorectal fistula and on the cultural demonstratio n of mycobacterium tuberculosis in the stool. The lung tuberculosis wa s displayed by radiographic infiltrations in both upper lobes of the l ung and by the radiometric and cultural positive proof of tuberculosis bacteriae in sputum and gastric juice specimens. Both manifestations of tuberculosis were regressive under a fourfold combination of tuberc ulostatic therapy. Anorectal tuberculosis manifestations are extremely rare and are predominately found in developing countries. However, du e to the increasing number of immunocomprised patients such as HIV-pat ients, an elevated incidence of tuberculosis has been observed. Theref ore, a tuberculous origin should be considered for all chronic anorect al lesions especially in immunocompromised patients.