Concomitant axillary mycobacteriosis and neuro-sarcoidosis: diagnostic pitfalls.
There are many similarities between mycobacteriosis, in particular, tuberculosis, and sarcoidosis such as predominant intrathoracic localisation (even if all organs and tissues may be concerned), great variability of phenotypic expression, and granulomatous inflammatory reaction, caseous necrosis not being an absolute criterion of tuberculosis. Moreover, microbial (or mycobacterial?) agents may play a role in the pathogenesis of sarcoidosis which remains a diagnosis of exclusion particularly in atypical cases. The authors report a case of a non-immunocompromised female patient who presented, simultaneously, isolated axillary tubercular adenitis and neuro-sarcoidosis without any other localisation. This case illustrates the difficulty to distinguish between both of these two diseases and thus to choose an adequate treatment when diagnosis is not proven. Moreover, our patient (human leucocyte antigen B27 positive) presented symptoms of spondylarthritis which also may have a nosological link with tuberculosis or sarcoidosis.
Department of Internal Medicine and Infectious Diseases, Versailles Hospital, Le Chesnay, France. rmeckenstock@ch-versailles.fr
Roderich
R
Meckenstock
Audrey
A
Therby
Catherine
C
Chapelon-Abric
Chantal
C
Nifle
Jean Paul
JP
Beressi
Constance
C
Lebas
Alix
A
Greder-Belan
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D001365:Axilla; D001927:Brain Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000175:diagnosis* / Q000188:drug therapy; D012507:Sarcoidosis / Q000175:diagnosis* / Q000188:drug therapy; D025241:Spondylarthritis / Q000175:diagnosis
D000305:Adrenal Cortex Hormones; D000995:Antitubercular Agents