Tuberculous Enteritis Presenting as Acute Appendicitis and Perirectal Abscess

Abstract

Mycobacterium tuberculosis has a wide variety of presentations. A rare occurrence is gastrointestinal tuberculosis. It may occur anywhere along the alimentary canal but usually occurs in the ileocecum with rare involvement of the appendix.

Figure 1

(a, b) PA CXR showing biapical pleural thickening associated with parenchymal scarring, bronchiectasis, nodularity, and superimposed infiltrates.

Figure 2

Solid white arrow outlining fluid-filled appendix suggestive of appendicitis.

Figure 3

Solid dense arrow delineating perirectal abscess in the saggital (a) and coronal (b) view of the abdominal CT scan.

Figure 4

(a) Diffuse airspace patchy consolidation with distention of bronchi and fluffy infiltrates. (b) Dense consolidation in the superior aspect of the right lower lobe with air bronchograms.

Figure 5

Granulomatous appendix (2x; 20 magnification).

Figure 6

(a, b) H&E stain showing granulomatous inflammation of the appendix with solid black arrows depicting multinucleated giant cells. Central necrosis can be seen in image A outlined by solid white arrow (10x; 100).

Figure 7

Solid black arrow depicting Ziehl-Neelsen AFB stain positive for acid-fast positive bacilli in the cytoplasm of a multinucleated giant cell (60x; 600).