VOLUME 55 , ISSUE 4 ( October-December, 2013 ) > List of Articles
Kranti Garg, Niti Singhal, D. Aggarwal, R. Gupta, A. Khurana, A.K. Janmeja
Keywords : Tuberculosis, Sarcoidosis, Lymph node, Acid-fast bacilli, Corticosteroid treatment
Citation Information : Garg K, Singhal N, Aggarwal D, Gupta R, Khurana A, Janmeja A. Tuberculosis Lymphadenitis in a Well Managed Case of Sarcoidosis. Indian J Chest Dis Allied Sci 2013; 55 (4):217-220.
DOI: 10.5005/ijcdas-55-4-217
License: CC BY-NC 4.0
Published Online: 16-06-2022
Copyright Statement: Copyright © 2013; The Author(s).
Differentiation between tuberculosis (TB) and sarcoidoisis is sometimes extremely difficult. Sequential occurrence of sarcoidosis and TB in the same patient is uncommon. We present the case of a young man, with a proven diagnosis of sarcoidosis who later developed TB after completion of treatment for sarcoidosis. A 32-year-old male patient presented with low-grade fever since two months. Physical examination revealed cervical lymphadenopathy. Initial fine needle aspiration cytology (FNAC) of the cervical lymph node was suggestive of granulomatous inflammation; the chest radiograph was normal. Repeat FNAC from the same lymph node was suggestive of reactive lymphoid hyperplasia. The patient was treated with antibiotics and followed-up. He again presented with persistence of fever and lymphadenopathy and blurring of vision. Ophthalmological examination revealed uveitis, possibly due to a granulomatous cause. His repeat Mantoux test again was non-reactive; serum angiotensin converting enzyme (ACE) levels were raised. This time an excision biopsy of the lymph node was done which revealed discrete, non-caseating, reticulin rich granulomatous inflammation suggestive of sarcoidosis. The patient was treated with oral prednisolone and imporved symptomatically. Subsequently, nearly nine months after completion of corticosteroid treatment, he presented with low-grade, intermittent fever and a lymph node enlargement in the right parotid region. FNAC from this lymph node showed caseating granulomatous inflammation and the stain for acid-fast bacilli was positive. He was treated with Category I DOTS under the Revised National Tuberculosis Control Programme and improved significantly. The present case highlights the need for further research into the aetiology of TB and sarcoidosis.