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Pneumopericardium complicating invasive pulmonary aspergillosis: case report and review
A E van Ede1, J F Meis, R A Koot
1Dept. of Haematology, University Hospital Nijmegen, The Netherlands.
Abstract:
Pneumopericardium, the presence of air in the pericardial space, is a rare disorder that is usually caused by trauma. We describe a patient given induction chemotherapy for acute myelogenous leukemia who developed pulmonary aspergillosis that resulted in pericarditis and pneumopericardium. He responded to antifungal treatment and recovered from granulocytopenia, but died early during the next course of chemotherapy. Two other reported cases of pneumopericardium associated with pulmonary aspergillosis are summarized.
Insights
Pneumopericardium, a rare condition of air in the pericardial sac, can arise from pulmonary aspergillosis in acute myelogenous leukemia patients. This case highlights a potential complication of chemotherapy and invasive fungal infections.
Area of Science:
- Cardiology
- Pulmonology
- Hematology Oncology
Background:
- Pneumopericardium is a rare condition characterized by air in the pericardial space, typically resulting from trauma.
- Acute myelogenous leukemia (AML) treatment involves induction chemotherapy, which can lead to immunosuppression and increased risk of opportunistic infections.
Observation:
- A patient with acute myelogenous leukemia undergoing induction chemotherapy developed pulmonary aspergillosis.
- The pulmonary aspergillosis led to secondary pericarditis and pneumopericardium.
Findings:
- The patient's pneumopericardium and pericarditis were associated with invasive pulmonary aspergillosis.
- While the patient showed initial improvement with antifungal treatment and recovery from granulocytopenia, the outcome was ultimately fatal during subsequent chemotherapy.
Implications:
- This case underscores a rare but serious complication of invasive fungal infections in immunocompromised patients undergoing chemotherapy.
- Highlights the importance of considering and managing invasive aspergillosis in patients with hematologic malignancies presenting with unusual thoracic findings.
- Suggests a potential link between pulmonary aspergillosis and pneumopericardium, warranting further investigation in similar clinical scenarios.