What makes the diagnosis of pulmonary sarcoidosis more difficult for the primary care physician? The pulmonary symptoms that accompany sarcoidosis, if any symptoms are present, typically include cough and dyspnea. Wheezing may also be present. These symptoms are nonspecific, and they may accompany many respiratory disorders. Since bronchitis and asthma are much more common respiratory diseases, treatment with bronchodilators, aerosolized steroids, and antibiotics is a reasonable initial approach. Indeed, patients may report improvement in their symptoms with such treatment. As bronchitis and asthma can be managed very well, much of the time, without ever obtaining a chest radiograph, a delay in the diagnosis of sarcoidosis when pulmonary symptoms are present begins to be more understandable.