Background:  Sarcoidosis is believed to be a rarity in Native Saudi.  Association between HIV and sarcoidosis is established in the literature. Sarcoidosis typically presents with asymptomatic chest radiograph findings, exertional breathlessness, and cough.  The overlap of their symptoms makes their diagnosis as distinguished entities quite challenging. The outcome of sarcoidosis is favorable with or without the presence of HIV.

  Case Report:  We present a case of 55-year-old native Saudi male that presented with 2-year history of weight loss, fatigability, abdominal pain, tongue pain and cyclic fever. The diagnosis of sarcoidosis was based lung tissue biopsy showing non-ceseating granuloma and exclusion of other differential. HIV was diagnosed by PCR. The patient had a favorable outcome with corticosteroids and Highly Active Antiretroviral Therapy. Conclusions:  Sarcoidosis is still under diagnosed and has not been properly studied in Saudi Arabia. Sarcoidosis associated with HIV is quite rare and diagnosis is challenging and the association between the two pathologies needs to be studied in Saudi Arabia.

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Multidisciplinary effort and cooperation between different medical and surgical services is important for timely diagnosis and appropriate management. Outcome of Sarcoidosis in HIV infected is similar to that of non-HIV infected patients. Involving patient and his beloved ones improve the dynamic of diagnosis and management dramatically.