Histoplasmosis presenting with joint pain and hilar adenopathy. "Pseudosarcoidosis".
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.
D000328:Adult; D001168:Arthritis; D003937:Diagnosis, Differential; D005260:Female; D006660:Histoplasmosis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D006984:Hypertrophy / Q000175:diagnosis; D007592:Joint Diseases / Q000188:drug therapy / Q000503:physiopathology; D007596:Joints; D008208:Lymphatic System / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010146:Pain; D012507:Sarcoidosis / Q000175:diagnosis*