Tuberculous effusion development in a patient with sarcoidosis during corticosteroid therapy

Abstract

A 47-year-old man was diagnosed a Lofgren's syndrome and corticosteroid therapy was started. On the seventh month of the therapy a pleural effusion developed. Although no definite diagnosis was made, anti tuberculous therapy was started empirically. Three weeks later mycobacterium growth was detected on Lowenstein-Jensen culture. The patient recovered almost completely in 2 months of the anti-tuberculous therapy. In a well controlled sarcoidosis patient who presents pleural effusion, if other causes are excluded, it would be wise to start anti-tuberculous therapy since sarcoid pleural effusion is a rare form of the disease which accompanies advanced disease and since corticosteroid therapy renders patients susceptible to tuberculosis.