Extra Pulmonary Tuberclosis

Dear Ask The Doctor: I had suffered Sarcoids in 2003, got treated for one year. Got completly cured. Now I am again experiencing same symptoms. I am having pain in my soles, and bones and am having constant temperature of 90C. I have got a swollen lymph node (of the size of a mrble) at the right of my throat, above my collar bone. I have got FNAC done for it and the result says Tuberclosis Lymphadentitis, but my Mountoux test is negative and Chest X-ray gives normal result. What it could be TB or Sarcoids. What is the difference between Sarcoidosis and tuberclosis.

Dear Shahida: The history and symtoms you have provided cleary indicates to what is known as extra pulmonary tuberculosis and it has been proven by FNAC also. The confusion you are having is due to negative Montoux and chest X-ray but let me tell you they both can be negative and still patient has TB.You needs to be put on ATT ( Anti tubercular therapy ) with consultation with your treating physician who is right person to decide the duration of treatment which would be definitily more than the duration for chest TB . You also need to get X ray of spines and bones which have pain, and an expert radiologist can pick the tubercular changes in them if you also have bone TB.

On the other hand Sarcoidosis is considered as auto immune by some and also linked to environmental toxins , it is said to come up when bodies immune system becomes weak like in TB , but mostly it has chest symtoms and comes up on chest X - ray , CT scan of chest can be of some help to diagnose but you definitily needs a pulmonologist opinion before any conclusion can be reached regarding sarcoidosis.