Clinical convergence: An exceptional case of sarcoidosis and tuberculosis with multiple organic manifestations. Case report

Néstor Correa-González , María Claudia Díaz , Keyla Jemihah Triana Ángel , María Daniela Polania , Natalia Remolina Murillo , Pilar Alarcón Robles
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Abstract

Introduction

The diagnosis of sarcoidosis is challenging, especially if the patient has concomitant infectious symptoms. Furthermore, the overlap of immune-mediated and infectious pathologies is not uncommon.

Objective

To report a rare case of association between tuberculosis and sarcoidosis

Materials and methods

Description of the clinical characteristics of a patient who presented with sarcoidosis superimposed on tuberculosis.

Results

The case of a 29-year-old man with ocular, cutaneous, and systemic symptoms is described. Uveitis and chronic non-caseating granulomatous findings were diagnosed in the skin, lungs, and lymph nodes. Suspicion of tuberculosis led to positive molecular biology tests only in the lymph node biopsy. An overlap of sarcoidosis and tuberculosis was determined, and combined treatment with glucocorticoids and anti-tuberculosis agents was initiated, resulting in improvement of the patient.

Conclusions

Sarcoidosis and tuberculosis share characteristics from their aetiology to clinical manifestations, posing a challenge in clinical differentiation. Cases have been documented where both diseases overlap in the same patient.
临床汇合:一例结节病合并肺结核,有多种器质性表现。病例报告
结节病的诊断是具有挑战性的,特别是如果患者有伴随的感染症状。此外,免疫介导和感染性病理的重叠并不罕见。目的报告一例罕见的结节病合并结核病病例。资料和方法描述一例结节病合并结核病患者的临床特征。结果一例29岁男性,眼部、皮肤和全身症状被描述。葡萄膜炎和慢性非干酪化肉芽肿的发现被诊断为皮肤,肺部和淋巴结。怀疑为肺结核,仅在淋巴结活检中分子生物学检测呈阳性。结节病与结核有重叠,开始联合糖皮质激素和抗结核药物治疗,使患者病情好转。结论结节病与结核在病因、临床表现等方面具有共同特点,临床鉴别具有一定难度。有记录的病例中,这两种疾病在同一患者重叠。
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