HANS E. EINSTEIN, M.D.
To the editor: In their article (Ann Intern Med 78:65-71, 1973), Winterbauer, Belic, and Moores categorically state that "bilateral hilar adenopathy in asymptomatic patients with negative physical examinations or in association with erythema nodosum or uveitis should be considered a priori evidence of sarcoidosis, and biopsy confirmation of the diagnosis is not necessary." In the Southwestern United States, where coccidioidomycosis occurs in various degrees of endemism, from the Oregon border south into Mexico and as far west as Texas, the clinical constellation described by the authors indicates progressive primary coccidioidomycosis much more commonly than sarcoidosis. The occurrence of erythema nodosum
EINSTEIN HE. Bilateral Hilar Adenopathy. Ann Intern Med. ;78:787. doi: 10.7326/0003-4819-78-5-787
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Published: Ann Intern Med. 1973;78(5):787.
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