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  1. I Litinsky,
  2. O Elkayam
  1. Tel Aviv Medical Centre, Israel

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    Authors’ reply

    Gaitonde et al raise the interesting issue of the influence of epidemiological data on clinical decisions. The differential diagnosis between tuberculosis and sarcoidosis is not easy and every case should be considered to be tuberculosis until proved otherwise, especially in countries where tuberculosis is endemic. It is less evident in countries where tuberculosis is not common. Likewise, the decision of giving routine isoniazid prophylaxis in patients treated with corticosteroids depends on the probability of exposure to Mycobacterium tuberculosis. Although the incidence of tuberculosis is undoubtedly increased in patients receiving corticosteroids in India,1 justifying the use of routine prophylaxis, this issue is still a matter of controversy in non-endemic areas.2 However, the ease of travel around the shrinking “global village” dissolves the boundaries between endemic and non-endemic regions and demands constant surveillance.


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