Abstract
IntroductionSarcoidosis 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 species. As these infections are mainly insidious and difficult to differentiate from the underlying disease, a possible misdiagnosis may lead to fatal complications for the patient.Case presentationWe present a case of a 67-year-old woman with undiagnosed asymptomatic stage I sarcoidosis for at least 8 years before her admission and a 1-month history of fever, exertional dyspnea and dry cough, in whom pulmonary tuberculosis was documented.ConclusionThis case highlights the need for great vigilance among physicians in order to rule out any possible infection before establishing the diagnosis of sarcoidosis.
Highlights
Sarcoidosis is a multisystem granulomatous disorder characterized pathologically by the presence of non-caseating granulomas in involved tissues
Depressed cellular immunity predisposes patients to opportunistic infections with certain intracellular organisms, mostly fungi, Mycobacterium tuberculosis and Nocardia species. The prevalence of these infecting organisms in patients with early stage untreated disease is rather infrequent. As these infections are mainly insidious and difficult to differentiate from the underlying disease, a possible misdiagnosis may lead to fatal complications for the patient [2]
We describe a patient with undiagnosed asymptomatic stage I sarcoidosis for at least 8 years before her admission and a 1-month history of fever, exertional dyspnea and dry cough, in whom pulmonary tuberculosis (TB) was documented
Summary
Sarcoidosis is a multisystem granulomatous disorder of uncertain etiology, characterized pathologically by the presence of non-caseating granulomas in involved tissues [1]. We describe a patient with undiagnosed asymptomatic stage I sarcoidosis for at least 8 years before her admission and a 1-month history of fever, exertional dyspnea and dry cough, in whom pulmonary tuberculosis (TB) was documented. She had been treated for presumed bronchitis with wide-spectrum antibiotics without response and her complaints had gradually worsened Her past medical history was significant for bilateral hilar lymphadenopathy, which was incidentally diagnosed on a routine chest radiograph 8 years previously, a finding that was confirmed, together with right paratracheal node enlargement, by a chest computed tomography (CT) scan. She had undergone a non-diagnostic bronchoscopy and was advised to repeat the chest CT scan after 6 months, advice she ignored.
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