Tuberculous Anal Fistula: A Case Series
Othmane Alaoui Abdellaoui *
Department of Proctology, Mohamed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Qamar Zaza
Department of Bacteriology, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Sarra Baziaa
Phthysiology and Pulmonology Department, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Crédo Freeman Espoir De Souza
Pathology Department, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Stéphane Ayee
Department of Proctology, Mohamed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Kaid Mohamed Kaid
Department of Proctology, Mohamed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
El Mostafa Benaissa
Department of Bacteriology, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Mariama Chadli
Department of Bacteriology, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Hicham Laraqui
Department of Proctology, Mohamed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Mohammed Tariq Tajdine
Department of Proctology, Mohamed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Anal tuberculosis is an uncommon form of extrapulmonary tuberculosis, frequently misdiagnosed as cryptoglandular anal fistulas due to similar clinical presentations. In a series of 8 cases observed in a proctologic surgery department, patients initially underwent conventional surgical treatment for the fistula, with a systematic referral of the fistulous tract for pathological examination. Pathological findings raised suspicion of tuberculosis, which was subsequently confirmed using diagnostic tools like the Quantideron test and Polymerase Chain Reaction. Following diagnosis, all patients were prescribed a 6-month course of antituberculous treatment. The treatment regimen led to favorable outcomes in all cases, highlighting the importance of considering tuberculosis in the differential diagnosis of anal fistulas, particularly in areas with a high prevalence of tuberculosis or in immunocompromised patients. Early detection and appropriate antituberculous therapy are essential for successful treatment of anal tuberculosis.
Keywords: Anal fistula, tuberculosis, perianal tuberculosis, extrapulmonary tuberculosis