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Ano‐perianal tuberculosis: 15 years of clinical experiences in Southern Taiwan
Author(s) -
Tai W.C.,
Hu T.H.,
Lee C.H.,
Chen H.H.,
Huang C.C.,
Chuah S.K.
Publication year - 2010
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2009.02057.x
Subject(s) - medicine , tuberculosis , family medicine , pathology
Objective Ano‐perianal tuberculosis (TB) is a rare extrapulmonary form of the disease. Most publications are in case report form. We report our cohort retrospective study on ano‐perianal TB, which is one of the very few original reports in the literature. Method Over a period of 15 years (January 1992–December 2006), file records revealed cases with confirmed diagnosis of ano‐perianal TB after screening from a total of 1251 patients with the diagnosis of TB from Chang Gung Memorial Hospital‐Kaohsiung, Taiwan. Results This study recruited 17 patients (14 male patients and 3 female patients). The age ranged from 18 to 81 years with a mean age of 44.8 ± 18.2 years. Thirteen patients had coexistent pulmonary TB (76.5%). Eight patients had at least one concomitant co‐morbid illness (47.1%). The most common clinical manifestations were anal fistulae ( n = 16). All patients who completed a full course of anti‐mycobacterial treatment for at least 6 months after surgical intervention were cured without recurrence except for one patient who was lost to follow‐up after 2 months of treatment. Seven of the nine patients with complicated fistulae needed longer anti‐mycobacterium treatment duration (9–18 months). Conclusion Ano‐perianal TB should be kept in mind for all patients with prolonged or repeatedly recurrent ano‐perianal symptoms and signs such as complicated fistulae in an endemic TB area like Taiwan. Management strategy is with conventional anti‐mycobacterium therapy for at least 6 months after surgery. An extension of the anti‐mycobacterium treatment course to 9–18 months is mandatory for patients with complicated disease presentations.