Baylon Simone Cristina, de Barros Marcos Dos Santos Vieira, Christiano Celso Guilherme, Lovisolo Silvana Maria, Rosa Vladimir Mulele Pinto Santa
Endoscopy Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil.
Department of Surgery - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil.
Autops Case Rep. 2014 Sep 30;4(3):65-69. doi: 10.4322/acr.2014.031. eCollection 2014 Jul-Sep.
The gastrointestinal (GI) tract has been increasingly affected by tuberculosis, especially in immunocompromised patients. Although strict rectal involvement is rare, the GI site mostly affected is the ileocecal region. Thus, tuberculosis should always be considered in the differential diagnosis of perianal and rectal lesions, and more so in patients infected by the HIV virus. The authors report the case of a 32-year-old man presenting a long-term history of fever, night sweats, weight loss, bloody diarrhea, fecal incontinence, tenesmus, and rectal pain. HIV serology was positive. The patient underwent anoscopy and biopsy, which disclosed the diagnosis of rectal tuberculosis. Thus the patient was referred to an outpatient clinic to follow the standard treatment.
胃肠道越来越多地受到结核病的影响，尤其是在免疫功能低下的患者中。虽然直肠受累情况严格来说较为罕见，但胃肠道最常受影响的部位是回盲部。因此，在肛周和直肠病变的鉴别诊断中应始终考虑结核病，在感染艾滋病毒的患者中更是如此。作者报告了一例32岁男性病例，该患者有长期发热、盗汗、体重减轻、血性腹泻、大便失禁、里急后重和直肠疼痛病史。艾滋病毒血清学检测呈阳性。患者接受了肛门镜检查和活检，结果确诊为直肠结核。因此，该患者被转诊至门诊接受标准治疗。
