Abstract
Pulmonary tuberculosis (TB) still forms a challenge in developing countries due to various forms of presentation, in spite of efforts taken by governments, non-governmental organisations (NGOs) and medical staff. Extrapulmonary TB is about 5% of all cases of TB, out of which perianal lesions constitute about 0.7%. The presence of hepatitis B surface antigen (HBsAg) positive disease with tuberculosis poses a challenge from both diseases, as regards the dilemma of treating the tubercular lesion with respect to hepatitis B surface antigen (HBsAg) positivity because of the compounding hepatotoxicity of anti-tubercular drugs and complications of cirrhosis and hepatocellular carcinoma. This is further complicated by a tuberculin test negativity, which in turn indicates a diminished immune status. This case report discusses a case of pulmonary and extrapulmonary (perianal) tuberculosis in a HBsAg positive patient.
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