Dr. Anteneh Gadisa Belachew

Extrapulmonary tuberculosis (TB) constitutes fewer than 15% of all TB cases. Within this category, perianal TB is particularly rare, accounting for under 1% of gastrointestinal TB cases. This report details the presentation and successful treatment of a 35-year- old man with a chronic perianal fistula yielding persistent purulent discharge, which a biopsy confirmed as secondary to TB. Combined surgical and pharmacological management led to a successful resolution. This case emphasizes the importance of including TB in the differential diagnosis for persistent, complex perianal fistulas, especially in settings where TB prevalence is high.