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Huge chronic pericardial effusion caused by Toxoplasma gondii
Insights
Chronic pericardial effusion can be caused by cardiac toxoplasmosis (Toxoplasma gondii). This parasitic infection should be considered in unexplained cases, especially in endemic regions, as the parasite may be detected in pericardial fluid.
Area of Science:
- Infectious Diseases
- Cardiology
- Parasitology
Background:
- Pericardial effusion, particularly when chronic and of unknown origin, presents a diagnostic challenge.
- Cardiac toxoplasmosis, caused by the parasite Toxoplasma gondii, is a recognized but often overlooked cause of cardiac pathology.
Observation:
- Two patients presented with large pericardial effusions lasting 9 and 14 years.
- Toxoplasma gondii organisms were identified within the pericardial fluid of both patients.
Findings:
- Serological tests confirmed active Toxoplasma gondii infection in both cases.
- The findings demonstrate that Toxoplasma gondii can be visualized in pericardial fluid during active toxoplasmic pericarditis.
Implications:
- Toxoplasmosis should be considered in the differential diagnosis of chronic pericardial effusion of unknown etiology.
- Cardiac toxoplasmosis may be a more frequent cause of chronic pericardial effusion in endemic areas than previously recognized.
Abstract:
Two patients who had a huge pericardial effusion of at least 9 and 14 years' duration caused by cardiac toxoplasmosis are reported. Toxoplasma gondii were seen in the pericardial fluid, and serologic evidence also demonstrated the activity of the infection. These cases illustrate both the need to exclude toxoplasmosis in chronic pericardial effusion of unknown cause and the possibility of seeing toxoplasma in the pericardial fluid of patients with active toxoplasmic pericarditis. Moreover, in endemic areas, cardiac toxoplasmosis may not be an exceptional cause of chronic pericardial effusion.