Introduction:

In the approach to patients with fever of unknown origin, it is important to take into account non-infectious inflammatory diseases, including connective tissue diseases, vasculitis and granulomatous diseases. Sarcoidosis is an idiopathic, chronic, multisystemic, granulomatous inflammatory disease and is a cause of fever of unknown origin.

Case presentation:

There is the case of a patient with fever and skin manifestations suggestive of endocarditis and painful nodular lesions in the pretibial region. This etiology was ruled out by transesophageal echocardiography, with negative blood cultures and without a clear infectious focus or response to broad-spectrum antibiotics. PET/CT was performed with evidence of lymphadenopathy in both pulmonary hila and skin biopsy evidence of granulomas without necrosis, without vasculitis, with septal infiltrate.

Conclusions:

By suggestive clinical picture and radiological findings, sarcoidosis is suspected and management is started with subsequent resolution of its picture.

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