Journal Article

Aspergillus Pericarditis with Tamponade: Report of a Successfully Treated Case and Review

Vincent Le Moing, Olivier Lortholary, Jean-François Timsit, Anne Couvelard, Claire Bouges-Michel, Michel Wolff, Loïc Guillevin and Philippe Casassus

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 26, issue 2, pages 451-460
Published in print February 1998 | ISSN: 1058-4838
Published online February 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516326
Aspergillus Pericarditis with Tamponade: Report of a Successfully Treated Case and Review

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We report a case of aspergillus pericarditis with tamponade complicating invasive pulmonary aspergillosis in a patient treated for acute lymphocytic leukemia. Prolonged antifungal therapy and aggressive surgical treatment cured the pericarditis, without relapse, despite the fact that the patient underwent autologous bone marrow transplantation. In a review of 28 other cases of aspergillus pericarditis, we found that this condition usually had occurred in severely immunocompromised patients and was always the result of contiguous dissemination of Aspergillus from the lung or myocardium. Tamponade was present in eight of 29 patients. Aspergillus antigen was detected in the pericardial fluid of all three patients whose fluid specimens were tested. Aspergillus pericarditis was diagnosed before death in 10 of 29 patients, all of whom had established premortem diagnoses of invasive aspergillosis at other sites and had received antifungal therapy. Three of the four survivors received combined medical and aggressive surgical therapies. The performance of echocardiography early during the course of invasive pulmonary aspergillosis, together with intensive combined therapies, might lower the high mortality associated with aspergillus pericarditis.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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