Candida Pericarditis in a patients with leukaemia

Area of Science:

• Infectious Diseases
• Cardiology
• Hematology

Background:

• Candidal pericarditis is an exceptionally rare fungal infection affecting the pericardium.
• Diagnosis and successful treatment of this condition are infrequently documented in medical literature.
• Acute lymphoblastic leukemia (ALL) is a hematologic malignancy that can predispose patients to opportunistic infections.

Observation:

• A 30-year-old male diagnosed with acute lymphoblastic leukemia presented with exudative pleuropericarditis.
• Persistent fever and positive blood and pericardial fluid cultures confirmed a diagnosis of Candida albicans infection.
• The patient exhibited clinical signs suggestive of a leukaemic origin for the initial pleuropericarditis.

Findings:

• Intravenous treatment with amphotericin B, flucytosine, and miconazole for three weeks resulted in the sterilization of blood and pericardial fluid.
• Therapeutic drug monitoring confirmed adequate amphotericin B levels in the pericardial fluid without the need for local instillation.
• This regimen demonstrated efficacy in eradicating Candida albicans from the pericardial space.

Implications:

• This case highlights the possibility of diagnosing and successfully treating invasive candidal pericarditis, even in immunocompromised patients.
• The findings support the use of systemic antifungal therapy for candidal pericarditis, achieving therapeutic concentrations in the pericardial fluid.
• This report contributes valuable clinical data for managing rare fungal infections in leukemia patients, guiding future therapeutic strategies.