A case report of purulent pericarditis caused by Candida albicans: Delayed complication forty-years after esophageal surgery. Issue 28 (July 2018)

• Record Type: Journal Article
• Authors: Sung, Joowhan; Perez, Irving Enrique; Feinstein, Addi; Stein, David Kidd
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 97:Issue 28(2018)
• Publication Date: 2018-07
• Subjects: candida pericarditis -- caspofungin -- colonic interposition -- echinocandin -- esophageal atresia; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000011286
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Candida pericarditis is a rare condition with high mortality. Risk factors include thoracic surgery and immunosuppression. We report a case of candida pericarditis which developed forty-years after esophageal reconstruction surgery. Patient concerns: A 42-year-old female presented with nausea, abdominal discomfort, and chest pain, and was found to have a cardiac tamponade secondary to candida pericarditis. Her notable risk factor was colonic interposition done during her infancy for esophageal atresia. Diagnoses: The patient underwent emergent pericardial window where 500cc of purulent fluid was drained. The pericardial fluid culture grew Candida albicans . Interventions: Esophagram did not show any visible leak and the patient improved with surgical drainage and antifungal treatment with Caspofungin. Caspofungin was continued intravenously for a total of four weeks and was switched to fluconazole. Outcomes: An Echocardiogram performed one month after pericardial window revealed trivial pericardial effusion. Serum beta-D-glucan at the time was negative. Lessons: This report highlights that candida pericarditis infection could occur as a late complication of colonic interposition. We also demonstrate the utility of using an echinocandin in treating this entity.