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Purulent pericarditis secondary to Candida parapsilosis and Peptostreptococcus species
1Department of Surgery, University of Alberta, Edmonton. cmcnamee@gpu.srv.ualberta.ca
Abstract:
Purulent pericarditis secondary to Candida pericarditis is a rare but lethal infection. The first case of pericardial infection by Candida parapsilosis in combination with Peptostreptococcus species in an immunocompetent nondebilitated individual is reported. Urgent pericardiectomy was required after pericardial drainage failed to stop symptoms of tamponade. The etiology, microbiology and treatment of this unusual condition are reviewed.
Insights
A rare Candida parapsilosis and Peptostreptococcus infection caused purulent pericarditis in an immunocompetent patient. Surgical pericardiectomy was necessary when drainage failed to resolve cardiac tamponade.
Area of Science:
- Infectious Diseases
- Cardiology
- Mycology
Background:
- Purulent pericarditis is a severe infection of the pericardium, often with high mortality.
- Candida species can cause invasive infections, particularly in immunocompromised individuals.
- Co-infections involving fungi and bacteria present unique diagnostic and therapeutic challenges.
Observation:
- This report details the first documented case of pericardial infection by Candida parapsilosis and Peptostreptococcus species in an immunocompetent, nondebilitated patient.
- The patient presented with symptoms of cardiac tamponade, indicating significant fluid accumulation around the heart.
- Initial management with pericardial drainage was insufficient to alleviate the patient's condition.
Findings:
- The causative agents were identified as Candida parapsilosis and Peptostreptococcus species, a rare polymicrobial etiology for purulent pericarditis.
- The infection led to severe symptoms of cardiac tamponade, necessitating urgent surgical intervention.
- Pericardiectomy, the surgical removal of the pericardium, was ultimately required for successful treatment.
Implications:
- This case highlights the potential for Candida parapsilosis and Peptostreptococcus to cause severe pericardial infections even in immunocompetent hosts.
- It underscores the importance of considering polymicrobial etiologies, including fungal-bacterial co-infections, in refractory cases of purulent pericarditis.
- The findings emphasize the critical role of prompt and aggressive surgical management, such as pericardiectomy, in life-threatening cases of infectious pericarditis unresponsive to less invasive treatments.