Tuberculosis or Sarcoidosis a Case Report

Distinguishing sarcoidosis from pulmonary tuberculosis can be a great challenge to physicians, especially in Tunisia where there is high prevalence of tuberculosis. Both tuberculosis and sarcoidosis are granulomatous diseases; however, necrosis is commun in tuberculosis and less commun in sarcoidosis. The presence of necrosis may lead to an excessive diagnosis of tuberculosis. We present the case of a 48 years old female in which nasosinusal tuberculosis was retained face to granulomatous inflammation with little fields of necrosis. The patient was treated for many months without healing. The diagnosis was revised when evolutive pulmonary lesions were observed while the patient was under well conducted anti-tubercular treatment. Sarcoidosis was in fine retained with good response to corticosteroid therapy.