Occam's razor or Hickam's dictum?

Sarcoidosis is a multisystemic, inflammatory disorder characterized by non-necrotizing granulomas that can infiltrate almost any organ but involves the lungs most commonly. The exact pathogenesis of sarcoidosis remains unclear. Histoplasmosis is an infection caused by Histoplasma capsulatum that also predominantly affects the lungs and is characterized usually by necrotizing granulomas. The similar clinical features of sarcoidosis and histoplasmosis often make it difficult to distinguish these 2 processes. We report a young man who had histopathologic evidence of histoplasmosis and subsequently developed sarcoidosis. The similar clinical and radiographic manifestations of sarcoidosis and histoplasmosis and a possible role of histoplasmosis as an etiologic agent for sarcoidosis are discussed.