Coccidioidal pericarditis: a rapid presumptive diagnosis by an in-house antigen confirmed by mycological and molecular methods.
Coccidioidal pericarditis is a condition found in approximately 1-5% of patients infected by Coccidioides species. It is associated with widely diverse clinical symptoms. This paper reports a case of coccidioidal pericarditis diagnosed by an in-house Coccidioides posadasii antigen and confirmed with mycological and molecular methods. From February to September 2005, the patient suffered from fever, weight loss, a non-productive cough, thoracic pain and tachycardia. He received a positive diagnosis of coccidioidal pericarditis only in October 2005. The macromorphological examination of the culture showed a whitish felt-like colony, which became brownish with age. Preparations in lactophenol cotton blue stain showed hyaline septate hyphae with fragmentation and thin arthroconidia-like structures. Pericardial fluid and sera samples were positive for Coccidioides antibodies by immunodiffusion and ELISA with a C. posadasii in-house antigen preparation. The C. posadasii identification was confirmed by nested PCR of the antigen 2/proline-rich antigen (Ag2/PRA) encoding gene.
Brilhante
Raimunda S N
RSN
Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil.|Postgraduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, Ceará, Brazil.|Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Cordeiro
Rossana A
RA
Postgraduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, Ceará, Brazil.|Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil.|Department of Biological Science, State University of Ceará, Fortaleza, Ceará, Brazil.|Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Rocha
Marcos F G
MFG
Postgraduate Program in Veterinary Science, State University of Ceará, Fortaleza, Ceará, Brazil.|Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil.|Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Fechine
Maria A B
MAB
Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Furtado
Felipe M
FM
Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Nagao-Dias
Aparecida T
AT
Department of Clinical and Toxicological Analysis, Federal University of Ceará, Fortaleza, Ceará, Brazil.|Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Camargo
Zoilo P
ZP
Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo, São Paulo, Brazil.
Sidrim
José J C
JJC
Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil.|Postgraduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, Ceará, Brazil.|Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil.
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D000946:Antigens, Fungal / Q000235:genetics / Q000276:immunology*; D003045:Coccidioides / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D003047:Coccidioidomycosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D005779:Immunodiffusion; D008297:Male; D016533:Mycological Typing Techniques; D010493:Pericarditis / Q000188:drug therapy / Q000382:microbiology*; D016133:Polymerase Chain Reaction
D000935:Antifungal Agents; D000946:Antigens, Fungal; D015725:Fluconazole