Purulent pericarditis complicating systemic infection with Candida tropicalis

Area of Science:

• Medical Mycology
• Infectious Diseases
• Cardiology

Background:

• Chemotherapy for Hodgkin's disease can increase susceptibility to opportunistic infections.
• Systemic fungal infections, particularly candidiasis, pose a significant risk in immunocompromised patients.
• Purulent pericarditis is a rare but severe cardiac condition.

Observation:

• A 77-year-old woman with Hodgkin's disease developed febrile episodes during chemotherapy.
• Despite broad-spectrum antibiotics, the patient's condition deteriorated, leading to expiration.
• Postmortem examination revealed purulent pericarditis, endocarditis, and myocarditis caused by Candida tropicalis.

Findings:

• Candida tropicalis was identified as the causative agent of purulent pericarditis, endocarditis, and myocarditis.
• This represents the first reported case of purulent pericarditis due to Candida tropicalis.
• The autopsy findings confirmed a fulminant course of fungal pericarditis.

Implications:

• Highlights the potential for Candida tropicalis to cause severe, invasive cardiac infections in immunocompromised individuals.
• Underscores the importance of considering fungal etiologies in febrile, septic patients, especially those with hematologic malignancies.
• Emphasizes the critical and often rapid progression of fungal pericarditis, necessitating prompt diagnosis and management strategies.