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Unusual presentation of more common disease/injury
Concomitant axillary mycobacteriosis and neuro-sarcoidosis: diagnostic pitfalls
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  1. Roderich Meckenstock1,
  2. Audrey Therby1,
  3. Catherine Chapelon-Abric2,
  4. Chantal Nifle3,
  5. Jean Paul Beressi4,
  6. Constance Lebas5,
  7. Alix Greder–Belan1
  1. 1Department of Internal Medicine and Infectious Diseases, Versailles Hospital, Le Chesnay, France
  2. 2Department of Internal Medicine, Pitié Salpétrière University Hospital, Paris, France
  3. 3Department of Neurology, Versailles Hospital, Le Chesnay, France
  4. 4Department of Diabetology and Endocrinology, Versailles Hospital, Le Chesnay, France
  5. 5Department of Gerontology, Versailles Hospital, Le Chesnay, France
  1. Correspondence to Dr Roderich Meckenstock, rmeckenstock{at}ch-versailles.fr

Summary

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.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.