[A rare case: Erasmus syndrome and tuberculosis]

We present the case of a 35-year-old male patient, sandblaster for eight years, recently diagnosed with pulmonary tuberculosis and systemic sclerosis, who was admitted with dyspnea and poor general condition. Chest X-ray showed a grade I pneumothorax, and on the chest tomography he presented confluent hyperdense masses associated with a pattern of non- specific interstitial pneumonia (NSIP), findings compatible with complicated silicosis. Due to the advanced clinical stage, neither invasive diagnostic test nor pulmonary function test could be performed. Initial treatment included placement of a pleural drainage tube, antituberculosis treatment and chronic home oxygen. The patient was referred to the interstitial disease and rheumatology departments for multidisciplinary management, although the infectious condition contraindicated the possibility of immunosuppressive treatment. The patient eventually died under palliative care. Silica inhalation is the cause of silicosis, but it is also implicated in the development of systemic sclerosis (Erasmus syndrome) and although they share a common risk factor, it is rare to find both diseases coexisting. We present the case of a young patient in whom both diseases presented aggressively, with the aim of highlighting the importance of actively searching for expositional diseases and associated conditions.