Isolated coccygeal tuberculosis.

A 47-year old female presented with a purulent discharge per anum for 14 months. During examination under anaesthesia a ‘sinus’ was found extending from six o’clock position at dentate line into the post-anal space. The primary opening was at the upper end of a fissure-in-ano (Figure 1). She underwent exploration of the post-anal space where a partially destroyed coccyx was found in an ‘abscess cavity’. The granulation tissues and parts of coccyx were sent for histopathology.The biopsy specimen consisted of multiple pieces of bone admixed with friable soft tissue, measuring 1 ́1 ́0.2 cm. Microscopy showed multiple well formed epithelioid granulomata with caseous necrosis surrounded by Langhan’s type multinucleated giant cells characteristic of typical tubercluous-granulomata (Figure 2). Stains for fungi excluded a possible fungal infection. Acid fast stains were inconclusive [1]. Because of the typical caseating epithelioid granulomata within the necrotic bony Isolated coccygeal tuberculosis