open access

Vol 87, No 4 (2019)
CLINICAL VIGNETTES
Published online: 2019-08-30
Submitted: 2019-05-11
Accepted: 2019-07-15
Get Citation

Pulmonary tuberculosis in a male with sarcoidosis

Marcin Skowroński, Anna Halicka, Aleksander Barinow-Wojewódzki
DOI: 10.5603/ARM.2019.0043
·
Pubmed: 31476015
·
Adv Respir Med 2019;87(4):252-253.

open access

Vol 87, No 4 (2019)
CLINICAL VIGNETTES
Published online: 2019-08-30
Submitted: 2019-05-11
Accepted: 2019-07-15

Abstract

Tuberculosis and sarcoidosis are chronic systemic diseases that have similar pulmonary and extra-pulmonary manifestations. It is likely that infection with Mycobacterium tuberculosis (MTB) is a common pathophysiologic mechanism for tuberculosis and sarcoidosis. We present a case of a patient with a primary diagnosis of sarcoidosis. The patient did not receive any immunosuppressive treatment till that time. Subsequently, smear-negative pulmonary tuberculosis was discovered, confirmed with the positive culture of bronchial washings and treated with antituberculous agents without major side effects. Both sputum smears and cultures were negative at the end of the treatment. It is worth highlighting that these two diseases share both clinical and histopathological features. Though it can be genuinely challenging to distinguish them, the precise and rapid diagnosis is crucial because the treatment is so different. Therefore MTB infection should be kept in mind in a broad differential diagnosis.

Abstract

Tuberculosis and sarcoidosis are chronic systemic diseases that have similar pulmonary and extra-pulmonary manifestations. It is likely that infection with Mycobacterium tuberculosis (MTB) is a common pathophysiologic mechanism for tuberculosis and sarcoidosis. We present a case of a patient with a primary diagnosis of sarcoidosis. The patient did not receive any immunosuppressive treatment till that time. Subsequently, smear-negative pulmonary tuberculosis was discovered, confirmed with the positive culture of bronchial washings and treated with antituberculous agents without major side effects. Both sputum smears and cultures were negative at the end of the treatment. It is worth highlighting that these two diseases share both clinical and histopathological features. Though it can be genuinely challenging to distinguish them, the precise and rapid diagnosis is crucial because the treatment is so different. Therefore MTB infection should be kept in mind in a broad differential diagnosis.

Get Citation

Keywords

tuberculosis, sarcoidosis, differential diagnosis

About this article
Title

Pulmonary tuberculosis in a male with sarcoidosis

Journal

Advances in Respiratory Medicine

Issue

Vol 87, No 4 (2019)

Pages

252-253

Published online

2019-08-30

DOI

10.5603/ARM.2019.0043

Pubmed

31476015

Bibliographic record

Adv Respir Med 2019;87(4):252-253.

Keywords

tuberculosis
sarcoidosis
differential diagnosis

Authors

Marcin Skowroński
Anna Halicka
Aleksander Barinow-Wojewódzki

References (5)
  1. Mootha VK, Agarwal R, Aggarwal AN, et al. The sarcoid-tuberculosis link: evidence from a high TB prevalence country. J Infect. 2010; 60(6): 501–503.
  2. Global tuberculosis report 2018. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO.
  3. Handa A, Dhooria S, Sehgal IS, et al. Primary cavitary sarcoidosis: A case report, systematic review, and proposal of new diagnostic criteria. Lung India. 2018; 35(1): 41–46.
  4. Dhooria S, Agarwal R, Aggarwal AN, et al. Differentiating tuberculosis from sarcoidosis by sonographic characteristics of lymph nodes on endobronchial ultrasonography: a study of 165 patients. J Thorac Cardiovasc Surg. 2014; 148(2): 662–667.
  5. Gupta D, Vinay N, Agarwal R, et al. Socio-demographic profile of patients with sarcoidosis vis-à-vis tuberculosis. Sarcoidosis Vasc Diffuse Lung Dis. 2013; 30(3): 186–193.

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