Folia Med (Plovdiv) 2019 Jun;61(2):312-316
Department of Pneumology, Cîmpeni City Hospital, Alba County, Romania.
Background: Sarcoidosis and tuberculosis are chronic diseases that rarely occur concomitantly. We present the case of a 39-year-old woman with microbiological confirmation of pulmonary tuberculosis and concomitant sarcoidosis. Four weeks after corticosteroid therapy for sarcoidosis was introduced we had positive findings of mycobacterium culture from bronchial aspirate. Based on these results, corticosteroid therapy was discontinued and the patient received anti-tuberculosis therapy for six months as required by the national guidelines. During this period, new nodes on face, nose, and ear appeared and the patient was diagnosed with skin sarcoidosis. The patient received colchicine and corticosteroids as per the national guidelines.
Conclusion: In cases of diagnostic uncertainty between sarcoidosis and tuberculosis we should administer corticosteroid therapy until we have microbiological confirmation of mycobacterium culture.