Fungal Pericarditis-A Systematic Review of 101 Cases
Predrag Jancic1, Stefan Milutinovic2, Marshall Ward3
1Mayo Clinic Health System, 1221 Whipple Street, Eau Claire, WI 54703, USA.
Microorganisms
|April 26, 2025
Summary
Fungal pericarditis, though rare, is increasing. Early antifungal therapy and procedures improve survival, but delayed diagnosis and immunosuppression contribute to high mortality rates.
Area of Science:
- Infectious Diseases
- Cardiology
- Mycology
Background:
- Fungal pericarditis incidence is rising with invasive fungal infections.
- It remains a rare but serious condition with significant mortality.
- Understanding its characteristics is crucial for improved patient outcomes.
Purpose of the Study:
- To systematically review and analyze cases of fungal pericarditis.
- To elucidate the etiology, clinical presentation, management, and outcomes.
- To identify factors influencing survival and mortality.
Main Methods:
- Systematic review of Medline and Scopus databases (1990-2024).
- Inclusion of case reports with fungal pathogen isolation from pericardial fluid/tissue.
- Analysis of 101 eligible cases.
Main Results:
- Candida, Aspergillus, and Mucor spp. were common pathogens.
- Immunosuppression (50% of cases) and disseminated disease were linked to worse outcomes.
- Early antifungal therapy, pericardiocentesis, and pericardiectomy improved survival.
Conclusions:
- Fungal pericarditis has a high mortality (up to 50%), often due to delayed diagnosis and treatment.
- Immunosuppression is a key risk factor.
- Further research is needed to improve diagnosis and management strategies.
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