Anal fistula: an unusual presentation of tuberculosis in a migrant health care professional.

Abstract

We present a case of a young health care professional from the Indian subcontinent, who presented with a low anal fistula and underwent exploration, debridement and fistulotomy twice. The initial working diagnosis was Crohn's disease. However, Mycobacterium tuberculosis, fully sensitive to all first-line drugs was cultured from the specimens sent from the second surgical procedure. On initiation of anti-tubercular therapy the symptoms improved within 5 weeks. The origin of the patient, high index of suspicion for non-infectious reactivation of tuberculosis in migrant health care workers, importance of a proper history taking including previous exposure and diagnostic workup is stressed.

• Authors: D Molloy, M K Sayana, J Keane, B Mehigan
• Journal: Irish journal of medical science (Ir J Med Sci) Vol. 178 Issue 4 Pg. 527-9 (Dec 2009) ISSN: 1863-4362 [Electronic] Ireland
• PMID: 18830735 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Health Personnel
• Humans
• Mycobacterium tuberculosis (isolation & purification)
• Rectal Fistula (microbiology, surgery)
• Transients and Migrants
• Tuberculosis (diagnosis, drug therapy)