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Infection leading to fistula is generally supposed to originate from an infected anal gland. The infection usually occurs from the bowel lumen, the patient swallowing the sputum laden with tubercle bacilli. This is the commonest route of infection in patients suffering from pulmonary tuberculosis. a rare case of anal tuberculosis is reported in a 37-year-old male patient with a recent anal fistula surgery and relapsing anal lesions. In total, the treatment course lasted 6 months and the patient showed signs of recovery in the early stages of the treatment (after 2 weeks), and complete remission was achieved. very often, the fistulas are formed from anal abscess but sometimes it can also occur due to sexually transmitted disease and infectious disorder like tuberculosis. An anal fistula may develop as well, as a result of a complication of surgery. Fistula-in-ano is a benign perianal condition that may be due to various etiological factors like repeated perianal infections, tb, diverticulitis, hidradenitis suppurativa, cancer of the anorectum, hiv infection, lymphogranuloma venereum, syphilis, secondary to trauma (e.). in the vast majority of cases, fistula-in-ano is caused by a previous anorectal abscess. Typically, there are eight to 10 anal crypt glands at the level of the dentate line in the anal canal. Anal fistula is among the most common illnesses affecting man. A case of anal tuberculosis in an otherwise asymptomatic patient with bleeding anal ulcers is presented. Chourak m, bentama k, chamlal i, raiss m, hrora a, sebbah f, benamer a, ahallat m. Pmid 20221764 pubmed - indexed for medline publication types case reports letter mesh terms. Adult antitubercular agentstherapeutic use humans rectal fistulacomplications rectal fistulasurgery tuberculosis. Tuberculosis can occur anywhere in the gastrointestinal tract. A 46-years-old male presented with abdominal pain and perianal discharge of 30 years duration. The patient had received operations for anal fistula and inflammation three times. To determine the frequency of tuberculosis in recurrent fistula-in-ano. This study was conducted in surgical ward-3, jinnah postgraduate medical centre, karachi, pakistan, from 1998.