Related Experiment Videos
Histoplasmosis presenting with joint pain and hilar adenopathy. "Pseudosarcoidosis"
Abstract:
During 2 recent epidemics of histoplasmosis in Indianapolis, 7 patients with hilar adenopathy and joint complaints were identified who were initially considered to have sarcoidosis, but in whom histoplasmosis was ultimately diagnosed on the basis of a positive culture for Histoplasma capsulatum or serologic studies. Articular features were the sole presenting complaints in 3 of these patients. All had arthralgias, which were generalized or confined to the lower extremities and were additive rather than migratory. Only 1 patient had joint swelling. Two had erythema nodosum. In all but 1 patient, the articular symptoms resolved rapidly and completely with minimal therapy. The data emphasize that sarcoidosis is a diagnosis of exclusion and that granulomatous infectious diseases must be excluded in patients with hilar adenopathy and joint disease.
Insights
Histoplasmosis can mimic sarcoidosis, presenting with joint pain and hilar adenopathy. Early diagnosis through cultures or serology is crucial for effective treatment of this fungal infection.
Area of Science:
- Infectious Diseases
- Rheumatology
- Pulmonology
Background:
- Histoplasmosis is a fungal infection that can present with symptoms mimicking other conditions.
- Hilar adenopathy and joint complaints are common in sarcoidosis but can also be seen in other granulomatous diseases.
Purpose of the Study:
- To highlight the importance of considering histoplasmosis in patients presenting with symptoms initially suggestive of sarcoidosis.
- To emphasize that histoplasmosis should be excluded in the differential diagnosis of hilar adenopathy and joint disease.
Main Methods:
- Retrospective review of 7 patients diagnosed with histoplasmosis during two recent epidemics.
- Diagnostic confirmation through positive cultures for Histoplasma capsulatum or serologic studies.
- Analysis of clinical presentation, focusing on articular features and hilar adenopathy.
Main Results:
- Seven patients initially suspected of having sarcoidosis were diagnosed with histoplasmosis.
- Articular symptoms, including arthralgias and erythema nodosum, were prominent in these patients.
- Most patients experienced rapid and complete resolution of symptoms with minimal intervention.
Conclusions:
- Histoplasmosis should be considered in the differential diagnosis of patients with hilar adenopathy and joint complaints.
- Sarcoidosis should be viewed as a diagnosis of exclusion, requiring the ruling out of infectious granulomatous diseases.
- Prompt diagnosis and treatment of histoplasmosis can lead to favorable outcomes.