Concomitant presentation of sarcoidosis and pulmonary tuberculosis with ARDS: A diagnostic dilemma and therapeutic challenge

摘要

Tuberculosis and sarcoidosis are chronic multisystem granulomatous conditions which have different aetiology and management but may mimic each other clinically, radiologi-cally and pathologically. Both these diseases usually have a sub acute or chronic presentation and it is rather uncommon for them to coexist or present with acute respiratory failure. We report a case of a 57-year-old male who presented with pyrexia of unknown origin with chronic cough. He was initially diagnosed to have sarcoidosis based on clinico-radiological and histologic evidence and was started on corticosteroids. However, he presented within two weeks with acute respiratory distress and on further investigation was diagnosed with co-existing pulmonary tuberculosis.