SARCOIDOSIS PRESENTING WITH PROLONGED FEVER IN A PATIENT WITH SICKLE-CELL-ANEMIA

Although the leading causes of fever and pulmonary infiltrates in sick le cell patients are acute bacterial pneumonia and the acute chest syn drome, the former is usually responsive to antibiotics and not protrac ted, and the clinical course of the latter is short and self-limited. A patient with sickle cell anemia presented with fever and pulmonary i nfiltrates of several weeks duration that were unresponsive to antibio tics. Gross endobronchial abnormalities were noted on bronchoscopy, an d the biopsies were consistent with sarcoidosis. The diagnosis of sarc oidosis can be difficult to establish in a patient with sickle cell an emia and protracted fever since both disorders are associated with chr onic interstitial changes on the chest radiograph as well as restricti ve physiology.