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Coccidioidal pericarditis: a case presentation and review of the literature

Edward L Arsura1, Ravi K Bobba, Chakradhar M Reddy

  • 1University of Virginia, Charlottesville, Virginia, USA. edward.arsura@med.va.gov

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|February 15, 2005
PubMed
Abstract

Insights

Coccidioidal pericarditis is a rare fungal infection with a poor prognosis. Early recognition of diagnostic clues is crucial for potentially improving patient outcomes in this serious condition.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Mycology

Background:

  • Pericardial involvement by Coccidioides immitis is rare and associated with a poor prognosis.
  • This study reviews coccidioidal pericarditis to improve clinical understanding of its presentation, complications, and outcomes.

Observation:

  • A literature review identified 16 cases, with one new case added, all in males (mean age 37.5).
  • Common symptoms included chest pain, dyspnea, and cough. Complications observed were pericardial tamponade (5 patients) and constriction (3 patients).
  • Diagnostic clues included cardiomegaly (10 patients), EKG abnormalities (low voltage, ST elevation), positive delayed hypersensitivity (9/9), and positive complement fixation titers (11/11).

Findings:

  • Coccidioidal pericarditis has a high mortality rate, with 53% of patients in the review dying.
  • Despite rarity, diagnostic indicators are often present, suggesting potential for earlier diagnosis.

Implications:

  • Enhanced understanding of clinical features can aid in earlier diagnosis and management of coccidioidal pericarditis.
  • Improved diagnostic strategies may lead to better outcomes for this severe fungal infection.

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