Miliary sarcoidosis following miliary tuberculosis.

A patient who presented with a miliary radiographic pattern due to tuberculosis and later with a similar miliary pattern due to sarcoidosis is described. The patient, a 47-year-old man, was admitted to the hospital due to coughing, weakness, weight loss and an abnormal chest radiograph with a miliary pattern. A gastric fluid culture was positive for Mycobacterium tuberculosis and he was treated appropriately. He showed complete clinical and radiological remission. One year later he presented with a dry cough and a similar miliary pattern on the chest roentgenogram. Lung biopsy taken by thoracoscopy revealed sarcoidosis. The patient had a complete remission with corticosteroids. To our knowledge, this is the first report describing a miliary pattern as presenting radiological sign in a patient with tuberculosis who subsequently developed a new miliary pattern due to sarcoidosis.