Sarcoidosis presenting as unilateral alveolar consolidation

Sarcoidosis is a multisystem granulomatous disorder that has variable clinical and radiologic manifestations. We describe a rare case of a 35-year-old black woman who had a nonresolving focal alveolar infiltrate. Her symptoms did not improve with the administration of antibiotics, and a more extensive workup, including fiberoptic bronchoscopy with transbronchial biopsy and a conjunctival biopsy showed noncaseating granulomata. We conclude that sarcoidosis should be included in the differential diagnosis of nonresolving alveolar opacity in populations that have increased incidence.