Acute appendicitis due to extrapulmonary tuberculosis

Tuberculous appendicitis is very infrequent, estimated to occur in only 0.1 % of all appendectomies. Appendicular tuberculosis can manifest as either a primary or secondary infection. Primary appendicular tuberculosis is even more uncommon and occurs in the absence of any detectable primary focus elsewhere in the body. In this report, we present a challenging case of primary tuberculous appendicitis that does not appear to have originated from the lungs. This case highlights the importance of considering tuberculosis in the differential diagnosis of appendicitis, especially in regions where tuberculosis is endemic or in patients with a history of tuberculosis exposure. Diagnosing tuberculous appendicitis can be challenging due to its rarity and the non-specific nature of its symptoms, which often mimic those of more common conditions such as acute appendicitis and because of these non-specific symptoms, tuberculous appendicitis is mostly diagnosed only after surgical intervention. This case underscores the need for a high index of suspicion and thorough diagnostic evaluation in patients with atypical presentations of appendicitis specifically in patients with chronic complaints. Treatment typically involves a combination of surgical intervention to remove the affected appendix and a prolonged course of anti-tuberculous medication to eradicate the infection and prevent recurrence.