A very rare presentation of extra-pulmonary tuberculosis discovered through acute appendicitis: a case report

Abstract Tuberculous appendicitis is a rare form of extra-pulmonary tuberculosis that commonly mimics acute appendicitis and is usually diagnosed only after histopathological examination. A 35-year-old man presented with a 1-year history of intermittent abdominal pain and mucoid diarrhea before developing acute right lower quadrant pain due to perforated appendicitis requiring emergency appendectomy. Histopathology revealed caseating granulomatous inflammation consistent with tuberculous appendicitis. The patient completed 6 months of standard anti-tubercular therapy with complete resolution of symptoms. Due to its nonspecific clinical and radiologic presentation, tuberculous appendicitis is rarely diagnosed preoperatively. Routine histopathological examination of appendectomy specimens remains essential for diagnosis. Combined surgical and medical management typically results in an excellent prognosis.