Isolated Rectal Tuberculosis in Immunocompetent Host

Area of Science:

• Gastroenterology
• Infectious Diseases
• Pathology

Background:

• Abdominal tuberculosis (TB) is a common extrapulmonary manifestation, frequently involving the ileocecal region.
• Isolated rectal TB is exceptionally rare, particularly in immunocompetent patients, often presenting with symptoms mimicking rectal carcinoma.
• Endoscopic biopsy yields for diagnosing submucosal rectal TB granulomas are historically low, frequently necessitating surgical resection for definitive diagnosis.

Observation:

• A middle-aged female presented with chronic diarrhea, exhibiting symptoms suggestive of a rectal malignancy.
• Diagnostic investigations focused on the rectal region due to persistent symptoms.
• The case highlights a rare presentation of tuberculosis localized to the rectum.

Findings:

• Rectal biopsy analysis revealed epithelioid cells forming granulomas, a key indicator of tuberculosis.
• Acid-fast bacilli were identified in the rectal biopsy, confirming the diagnosis of tuberculosis.
• The patient's presentation and biopsy results pointed towards isolated rectal tuberculosis.

Implications:

• This case underscores the importance of considering tuberculosis in the differential diagnosis of rectal masses, even in immunocompetent individuals.
• Improved diagnostic strategies for rectal TB may reduce the need for extensive surgical intervention.
• Early identification and treatment of rectal TB can prevent complications and improve patient outcomes.