Introduction: COVID-19 often leads to viral pneumonia. Its diagnosis is based on the isolation of the virus from nasopharyngeal samples by the RT-PCR test. It can be superinfected or associated with other pulmonary infectious pathologies, in particular tuberculosis in an endemic zone, making diagnosis by imaging complex. We report the case of a coexistence between miliary tuberculosis and COVID-19 in a teenager in Bouake. Objective: To show the radiological signs of coexistence between tuberculosis and COVID-19. Patient and Observation: A 17-year-old immunocompetent patient with the notion of tuberculosis contagion was consulted for febrile respiratory distress. The symptomatology went back to a month with a dry cough, chest pain and evening fever. Physical examination shows crackles. Faced with these signs, imaging and biological examinations were carried out. Results: The thoracic X-ray showed multiple central symmetrical diffuse micronodules without peripheral involvement. As for the scanner, it revealed bilateral micronodules and images of “ground glass” intra-parenchymal and under peripheral pleural estimated at more than 75% of the pulmonary surface. COVID-19 PCR was positive with isolation of SARS-CoV-2. In addition, Gene Xpert has been identified in gastric fluid. Conclusion: COVID-19 pneumonia is a new global pandemic that can coexist with other airway conditions, including tuberculosis in endemic areas. Diagnosis on imaging is difficult, but it must be known to evoke it in front of the association of the elementary signs of viral and bacterial pneumonia on CT scan.
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