Unexplained harmony; tuberculosis and sarcoidosis

Sarcoidosis and tuberculosis are chronic granulomatous diseases with predominant pulmonary involvement. Simultaneous occurrence of sarcoidosis and tuberculosis is a rarely encountered clinical entity. We present two Sri Lankan males with coexisting bacteriologically confirmed tuberculosis and histologically diagnosed sarcoidosis. Careful and timely commencement of anti-tuberculous treatment followed by steroids treatment for sarcoidosis lead to improvement of both conditions. These cases are reported to describe the dilemmas in diagnosis and management of this underrecognized clinical entity.