Rectal tuberculosis in a 48-years-old immuno-competent man: A rare case report

Rectal tuberculosis (TB) is one of the rare presentations of gastrointestinal tuberculosis that often mimics malignancy or inflammatory bowel disease (IBD), presenting as fistulas, ulcers, and chronic pain. Rectal TB is very rare in immunocompetent patients. The mainstay of diagnosis is colonoscopy-guided biopsy. Management rarely requires surgical interventions and is treated with anti-tubercular therapy responding well.

A 48-years-old man presented with rectal mass, per-rectal bleeding, and painful defecation, initially raising concerns of malignancy. Imaging and colonoscopy revealed ulceration, while histopathology confirmed granulomatous proctitis of tuberculous origin, which improved significantly with anti-tubercular therapy.

Rectal TB can mimic malignancy or IBD demanding early histopathological confirmation. Timely diagnosis and anti-tubercular therapy ensures favorable outcomes in affected patients.

Though rare, rectal TB should be considered as differential diagnosis in anorectal lesion, with early histopathological confirmation essential for effective treatment.