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Candida pericarditis: clinical profile and treatment
R Rabinovici1, D Szewczyk, P Ovadia
1Department of Surgery, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA. rabinov1@jeflin.tju.edu
The Annals of Thoracic Surgery
|April 1, 1997
Summary
Candida pericarditis is a rare but fatal emergency. Early diagnosis of unexplained fever and cardiac tamponade in at-risk patients, followed by drainage and antifungal treatment, is crucial for survival.
Area of Science:
- Infectious Diseases
- Cardiology
- Medical Mycology
Background:
- Candida pericarditis is a rare, life-threatening condition requiring prompt recognition.
- Identifying clinical features aids in the early diagnosis of this medical and surgical emergency.
Observation:
- The study reviewed 26 cases of Candida pericarditis over 30 years.
- Risk factors include immunocompromise (73%), antibiotic use (62%), and postpericardiotomy status (54%).
- Clinical presentation is often subtle, with unexplained fever, enlarged cardiac silhouette, or cardiac tamponade being key indicators.
Findings:
- Diagnosis is confirmed by positive Candida cultures in pericardial fluid or yeast in tissue.
- Combined pericardiocentesis, operative drainage, and antifungal therapy is the standard treatment.
- Untreated Candida pericarditis has a 100% mortality rate; prompt intervention leads to cure.
Implications:
- Fever and cardiac tamponade in susceptible patients should raise suspicion for Candida pericarditis.
- Diagnostic confirmation relies on identifying Candida in pericardial fluid or tissue.
- Aggressive treatment involving drainage and antifungals offers the best chance for a curative outcome.