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A clinical enigma of ongoing constrictive pericarditis
Deacon Zhao Jun Lee1, Reshma Amin2, John Baksi3
1East Sussex Healthcare NHS Trust, St Leonards-on-sea, UK; deacon.lee.04@aberdeen.ac.uk.
Clinical Medicine (London, England)
|June 3, 2017
Summary
A rare case of constrictive pericarditis was diagnosed in a 59-year-old woman, linked to a past infection with Strongyloides stercoralis. This highlights the importance of considering parasitic infections in unexplained cardiac conditions.
Area of Science:
- Cardiology
- Infectious Diseases
- Parasitology
Background:
- Constrictive pericarditis is a serious cardiac condition often caused by infections, inflammation, or radiation.
- Diagnosis can be challenging, especially when typical causes are ruled out.
Observation:
- A 59-year-old woman presented with symptoms of heart failure, including orthopnoea and paroxysmal nocturnal dyspnoea.
- Echocardiogram and cardiac MRI revealed pericardial thickening and constrictive physiology.
- Initial investigations for common causes like autoimmune diseases and tuberculosis were negative.
Findings:
- A serum sample tested positive for Strongyloides stercoralis, a parasitic nematode.
- The patient had a history of travel to Egypt 8 years prior, a potential source of infection.
- Strongyloides stercoralis infection was identified as the likely cause of the constrictive pericarditis.
Implications:
- This case underscores the importance of considering parasitic infections, such as Strongyloides stercoralis, in the differential diagnosis of constrictive pericarditis, even years after exposure.
- It highlights the need for thorough travel history and specific serological testing in patients with unexplained cardiac conditions.
- Early identification and treatment of Strongyloides stercoralis can prevent severe complications like constrictive pericarditis.
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