Isolated and fistulized primary appendicular tuberculosis: when a great pretender disguises herself

Tuberculosis in all its forms remains a public health problem in Morocco, despite the efforts of the state in terms of prevention and treatment. Recently, there has been an increase in the number of extra-pulmonary forms of TB. Isolated appendicular localization is very rare, especially since intestinal localization is only ranked 6th among extra-pulmonary localizations. We report the case of a 39 year old female patient admitted for right iliac fossa (RIF) pain evolving for two months, the clinical examination on admission objective a digestive fluid outlet through a fistulous orifice at the level of the RIF; the abdominal CT scan found a plastron with the presence of a fistulous path between a digestive segment and the wall, the surgical exploration found a fistula between the body of the appendix and the wall, an appendectomy was done and the anatomopathological examination confirmed the tuberculosis origin. Our work sheds light on an often-misunderstood form of a well-known pathology.