Sarcoidosis and Histoplasmosis: Is One a Consequence of the Other? A Case Report and Review of the Literature

Abstract

Sarcoidosis involves abnormal collections of inflammatory cells (granulomas) which may form as nodules in multiple organs. 90% of affected patients have respiratory tract abnormalities. We present a 61-year-old male with sarcoidosis who was admitted for respiratory distress. Fibrosing mediastinitis was seen in the chest computograph. Management was conservative and included steroids, antibiotics, and oxygen therapy. Sarcoidosis and fibrosing mediastinitis are rare. Fibrosing mediastinitis is more commonly seen with histoplasmosis. We explore the clinical similarities between histoplasmosis and sarcoidosis. We also explore the potential cause and effect relationship and workup for each disease entity.

Sarcoidosis and Worsening Lymphadenopathy: Sarcoidosis Flare? Think Again!

“…Histoplasmosis is the most prevalent endemic mycosis in the US and is mainly found in Ohio and Mississippi river valleys as well as in southeastern states (1). Sarcoidosis and histoplasmosis can present very similarly, involving uveitis, arthralgias, skin ulcers, erythema nodosum, splenomegaly, and hepatitis, with similar radiologic findings of hilar lymphadenopathy and reticulonodular opacities (2). The most common findings in disseminated histoplasmosis include splenomegaly (72.0%), hepatomegaly (68.1%), and lymphadenopathy (41.2%) (3).…”

A Comprehensive Review of Infectious Granulomatous Diseases of the Gastrointestinal Tract

“…However, Histoplasmosis can also present as noncaseating granulomas but appear fewer in number (<2 granulomas per slide) with ragged borders. This is in contrast to Sarcoidosis, which demonstrates numerous granulomas (>10 per slide) with clearly defined, sharp borders [ 34 , 42 ].…”