en Infectious Disease Infectious Disease case report case report <p>  Silicosis is considered to be among the occupational lung diseases and associated with sandblasting, mining, quarrying and tunneling. Acute silicosis is usually progressive diseaseand despite treatment with corticosteroids it leads to cardio-respiratory failure and death. Alveolar silicoproteinosis is one of it’s acute presentations due to exposure to silica dust and lungs filling with proteinaceous material. Here, we have presented a 29 year old male sandblaster with the three conditions of acute silicosis, secondary alveolar proteinosis and pulmonary tuberculosis on four anti tuberculous medications who presented with respiratory distress. </p><p> <strong> </strong></p> Silicotuberculosis, Silicosis, Pulmonary Alveolar Proteinosis, Tuberculosis, Drug-Resistant. 144 149 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-651&slc_lang=en&sid=1 Ali Cheraghvandi cheraghvandi@yahoo.com 200319475328460012938 200319475328460012938 No Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Saeid Fallah Tafti saeid-ftafti@yahoo.com 200319475328460012939 200319475328460012939 No Nursing and Respiratory Health Management Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Firouzeh Talischi firouzehtalischi@yahoo.com 200319475328460012940 200319475328460012940 No Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Seyed Mohammad Seyedmehdi mseyedmehdi@gmail.com 200319475328460012941 200319475328460012941 Yes Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Elham Ghazanchaei el_gh2008@yahoo.com 200319475328460012942 200319475328460012942 No Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Beheshteh Jebelli sam_jeb@yahoo.com 200319475328460012943 200319475328460012943 No Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mihan Pourabdollah mihanp@yahoo.com 200319475328460012944 200319475328460012944 No Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.