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(Chest. 1973;63:488-494.)
© 1973 American College of Chest Physicians

Sarcoidosis and Specific Etiologic Agents: A Continuing Enigma

Gerald L. Baum M.D. F.C.C.P.1; Jan Schwarz M.D.2; and Peter B. Barlow M.D., F.C.C.P.3

1 Chief, Pulmonary Section B., Veterans Administration Hospital, Cleveland; Professor of Medicine, Case Western Reserve University School of Medicine, Cleveland
2 Associate Director, Clinical Laboratories Jewish Hospital; Director, Mycology Laboratories, General Hospital; Professor of Pathology, University of Cincinnati College of Medicine, Cincinnati
3 Pulmonary Section, Veterans Administration Hospital, Cleveland; Assistant Professor of Medicine, Case Western Reserve University School of Medicine, Cleveland

Twelve cases are presented in which a diagnosis of sarcoidosis was made, but from which specific infectious agents capable of eliciting a granulomatous response were identified. The etiologic role of these agents must be seriously entertained, inspite of occasional fairly significant time intervals between the original diagnosis of sarcoidosis and the recovery of the organisms. Strict clinical and morphologic criteria for the diagnosis of sareoidosis should be applied. These include searching for an infectious cause, which must be done in every case, by vigorously applying adequate cultural and special histologic techniques. The existence of a granulomatous disease in which initial evaluation does not uncover a specific etiologic agent compels the physician to restudy such patients periodically, since these specific agents may appear months or years later. Restudy will, in addition, provide better material for culture, since the need for it will be more greatly appreciated.




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D. M. Skillrud, G. L. Baum, and J. Reich
Sarcoidosis Cycle
Chest, March 1, 2004; 125(3): 1171 - 1172.
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