Muntean Petru-Emil
Department of Pneumology, Cîmpeni City Hospital, Alba County, Romania.
Folia Med (Plovdiv). 2019 Jun 1;61(2):312-316. doi: 10.2478/folmed-2018-0055.
Sarcoidosis and tuberculosis are chronic diseases that rarely occur concomitantly. We present the case of a 39-year-old woman with microbiological confirmation of pulmonary tuberculosis and concomitant sarcoidosis. Four weeks after corticosteroid therapy for sarcoidosis was introduced we had positive findings of mycobacterium culture from bronchial aspirate. Based on these results, corticosteroid therapy was discontinued and the patient received anti-tuberculosis therapy for six months as required by the national guidelines. During this period, new nodes on face, nose, and ear appeared and the patient was diagnosed with skin sarcoidosis. The patient received colchicine and corticosteroids as per the national guidelines.
In cases of diagnostic uncertainty between sarcoidosis and tuberculosis we should administer corticosteroid therapy until we have microbiological confirmation of mycobacterium culture.
结节病和结核病是很少同时发生的慢性疾病。我们报告一例39岁女性，经微生物学证实患有肺结核且合并结节病。在开始针对结节病的皮质类固醇治疗四周后，我们从支气管吸出物中培养出分枝杆菌呈阳性。基于这些结果，停用皮质类固醇治疗，患者按照国家指南接受了六个月的抗结核治疗。在此期间，患者面部、鼻子和耳朵出现新的结节，被诊断为皮肤结节病。患者按照国家指南接受了秋水仙碱和皮质类固醇治疗。
在结节病和结核病诊断不确定的情况下，我们应给予皮质类固醇治疗，直到分枝杆菌培养获得微生物学证实。
