Yusuf KA, Kanhosh SF, Al-Madani AH. Coexistence of pulmonary tuberculosis with pulmonary sarcoidosis and skin sarcoidosis: a case report.
Egypt J Intern Med 2023;
35:35. [PMID:
37214760 PMCID:
PMC10184060 DOI:
10.1186/s43162-023-00221-4]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/07/2023] [Indexed: 05/24/2023] Open
Abstract
Background
Necrotising granulomatous diseases of the lungs exhibit a narrow range of differential diagnoses. Tuberculosis accounts for most of these cases, while sarcoidosis is an uncommon entity in this group but both possess similar clinical and radiological similarities. One must consider a diagnosis of sarcoidosis once the standard anti-mycobacterial medications fail to achieve a clinical improvement. The case described highlights the coexistence of tuberculosis and sarcoidosis which is a rare entity in the medical literature.
Case presentation
A 57-year-old male presented with respiratory symptoms and was diagnosed with tuberculosis (TB) demonstrating a polymerase chain reaction (PCR) test positive showing microbial DNA in bronchial washing. The patient started standard anti-TB treatment; however, he did not respond initially. Further investigations led us to diagnose pulmonary followed by skin sarcoidosis, based on histology. After confirmation of sarcoidosis, administered corticosteroids for 6 months simultaneously along with anti-TB treatment; however, anti-TB treatment was prolonged for a total of 9 months. The patient was found clinically symptomless after the completion of treatment during subsequent follow-ups.
Conclusion
The use of corticosteroids as an adjunct with standard anti-TB treatment proves beneficial effects on the recovery of patients having a coexistence of pulmonary mycobacterium tuberculosis and sarcoidosis disease conditions.
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