Complex Perianal Fistulas as an Unusual Presentation of Tuberculosis: A Case Report

Gastrointestinal tuberculosis at the perianal level is one of the rarest cases of extrapulmonary tuberculosis, representing less than 1% of cases. Due to its low incidence, it is necessary to take this differential diagnosis into account, facilitating early diagnosis and timely treatment of tuberculosis. This clinical case presents a patient with unstudied chronic lower back pain accompanied by constipation, pain in the perianal area and hematochezia. Physical examination revealed complex perianal fistulas. The suspected diagnosis begins with a chest computed tomography, that shows lesions at the vertebral level compatible with vertebral tuberculosis (Pott's Disease). The culture was positive for Mycobacterium tuberculosis, initiating anti-tuberculosis treatment.