title: Ano-perianal tuberculosis--solving a clinical dilemma.
abstract: BACKGROUND
  Tuberculosis is one of the causes of granulomatous disease within the anorectal region. The clinical features, which include symptoms and signs of anal pain or discharge, multiple or recurrent fistula in ano and inguinal lymphadinopathy, are not characteristically distinct from other anal lesions. It is also difficult to distinguish it from other granulomatous diseases involving the same area.
  
  
  METHODS
  A Medline database was used to perform a literature search for articles relating to the term 'anal', 'tuberculosis' and 'Koch's'.
  
  
  CONCLUSIONS
  Analysis of the available literature shows that Koch's lesion in and around the anus is not uncommon. The presentation is varied in nature and tuberculosis should be suspected in lesions not responding to the conventional approaches. The treatment is two-fold: surgical for the suppuration and medical for the tuberculosis.
authors.affiliation: Consulting Proctologist, Gupta Nursing Home, D/9 Laxminagar, Nagpur, India. drpjg_ngp@sancharnet.in,
authors.forename: P J
authors.initials: PJ
authors.lastname: Gupta
mesh_terms: D001004:Anus Diseases / Q000382:microbiology* / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D013492:Suppuration; D014376:Tuberculosis / Q000175:diagnosis* / Q000473:pathology