Tuberculosis and Sarcoidosis Overlap: A Clinical Challenge From Diagnosis to Treatment

Tuberculosis (TB) and sarcoidosis have clinical, immunologic, and radiologic similarities and the differential diagnosis is often a challenge. Some cases are described in which patients have both diseases concomitantly. There is a hypothesis that posits TB and sarcoidosis as being along the spectrum of the same disease. This has important implications for treatment decisions, since immunosuppression, which is a treatment for sarcoidosis, is undesirable in TB patients. We are going to describe a clinical case of a TB patient who developed more severe symptoms during the course of TB treatment and, after excluding TB progression or resistance, he was diagnosed as probable sarcoidosis. He was started on immunosuppression, with great improvement, finishing the TB treatment completely asymptomatic.