Sporotrichosis and Sarcoidosis

There have been four reports of systemic sporotrichosis developing in patients after an initial diagnosis of sarcoidosis. We have recently seen a fifth patient who had both diseases. The coexistence of these two uncommon diseases suggests that there is a meaningful relationship between them. This relationship could be interpreted in two ways. An unrecognized infection with Sporotrichum schenckii might have caused the noncaseating epithelioid granulomas which were then erroneously diagnosed as sarcoidosis. Or alternately, opportunistic infection with S schenckii might have occurred in patients with true sarcoidosis. A final choice between these two explanations is impossible at this time, but steroid treatment in three patients and the abnormalities in immune response which are known to occur in sarcoidosis lead us to favor the second explanation.