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Skeletal Radiol. Tuberculosis of the rectum in a patient with acquired immune deficiency syndrome: anal fistula with tuberculosis of a case. The abscess had formed a fistula to the perianal region, indicating perianal abscess. Two possible explanations are as follows: first, hematogeneous spread after reactivation of latent lung TB could be responsible[ 7 ], and second, other foci may have not been sufficiently investigated, as seen in our cases wherein only 37 Acid-fast bacilli were detected in the sputum and wound pus and PCR anal fistula with tuberculosis culture analysis confirmed Mycobacterium tuberculosis. The biopsy showed chronic granulomatous proctitis Fig.