P Prasanth*, N C Kajal, K T Nithin, Vikas Kumar and Ritu Dadra
Tuberculosis (TB) and sarcoidosis are multisystem diseases having different etiology and management; however, they have similar clinical and histological characteristics, that may rarely coexist. The emergence of Extensively Drug-Resistant Tuberculosis (XDR-TB) is a challenging paradigm shift faced by the TB control programs worldwide. The treatment is further compounded with unique management difficulties. Treatment of XDR-TB requires prolonged chemotherapy with second-line anti-TB drugs, which offer lesser potency and increased risk of drug related side effects. Sarcoidosis is a multisystem granulomatous disorder characterized pathologically by the presence of non-caseating granulomas in involved tissues. Depressed cellular immunity predisposes patients to infections with certain intracellular organisms, mostly fungi, Mycobacterium tuberculosis and Nocardia. As these infections are mainly insidious and difficult to differentiate from the underlying disease, a possible misdiagnosis may lead to fatal complications. This case highlights the high index of suspicion required in order to identify any possible infection in a case of sarcoidosis. A case of a 66-year-old female with 3-months history of fever, exertional dyspnea and dry cough, in whom extensively drug resistant tuberculosis was documented with co-existence of sarcoidosis. This case highlights the high index of suspicion required in order to identify any possible infection in a case of sarcoidosis.
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