Purulent pericarditis caused by Candida species: case report and review.
Purulent pericarditis caused by Candida species is a rare and often undiagnosed disease. We recently treated a patient in whom purulent pericarditis due to Candida albicans developed following thoracic surgery. The patient survived after receiving a combination of surgical and medical therapy. A literature review revealed 24 additional cases of purulent pericarditis caused by Candida species. Twenty-one of the patients either had undergone thoracic surgery or had had disseminated candidiasis. None of the 12 patients described before 1980 survived, whereas six (46%) of the 13 patients described after 1980 survived. No patient survived without pericardiectomy (five of six survivors) or at least pericardiocentesis (one survivor). All survivors received full courses of amphotericin B therapy. An increased utilization of echocardiography, along with an increased recognition of the patient populations at risk, has been instrumental in early detection and improved outcome of purulent pericarditis. A combination of prolonged amphotericin B therapy and pericardiectomy appears to be the best approach for achieving a cure.
Schrank
J H
JH
Department of Medicine, Dwight David Eisenhower Army Medical Center, Fort Gordon, Georgia 30905, USA.
Dooley
D P
DP
D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002176:Candida albicans / Q000302:isolation & purification*; D002177:Candidiasis / Q000209:etiology* / Q000628:therapy; D004452:Echocardiography; D006801:Humans; D008297:Male; D010490:Pericardial Effusion / Q000382:microbiology; D010492:Pericardiectomy; D010493:Pericarditis / Q000382:microbiology* / Q000628:therapy; D013903:Thoracic Surgery
D000935:Antifungal Agents; D000666:Amphotericin B