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Published on: November 6, 2020
Purulent pericarditis complicating systemic infection with Candida tropicalis
Abstract:
A patient with a purulent pericarditis due to Candida tropicalis is described. A 77-year-old woman undergoing chemotherapy for Hodgkin's disease was admitted to the hospital with a history of several febrile episodes. She was thought to be septic and was begun on broad-spectrum antibiotics, despite treatment, however, the patient expired. Among the multiple premortem blood, urine, and cerebrospinal fluid cultures, one blood culture yielded C. tropicalis 2 days postmortem. Autopsy revealed purulent pericarditis accompanied by endocarditis and myocarditis due to culture-proven C. tropicalis. This is the first reported case of purulent pericarditis complicating systemic infection with this organism and is indicative of the fulminant course of fungal pericarditis.
Insights
This case report details a fatal instance of purulent pericarditis caused by Candida tropicalis in a patient undergoing chemotherapy. The rare fungal infection led to severe cardiac inflammation and ultimately, the patient
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.
Related Concept Videos
Endocarditis I: Introduction
Endocarditis II: Clinical Features of Infective Endocarditis
Pericarditis I: Introduction
Pericarditis II: Clinical Features and Diagnostic Tests
Cryptococcal Meningitis
Candidiasis

