Author/Authors :
Soriano, Paolo K. Department of Internal Medicine - Southern Illinois University, USA , Iqbal, Muhammad Department of Internal Medicine - Southern Illinois University, USA , Kandaswamy, Shakthishri Department of Internal Medicine - Southern Illinois University, USA , Akram, Sami Infectious Disease - Southern Illinois University, USA , Kulkarni, Abhishek Division of Cardiology - Southern Illinois University, USA , Hudali, Tamer Clinical Internal Medicine - Southern Illinois University, USA
Abstract :
The common causes of pericarditis and its course are benign in the majority of cases.Thus, further testing is usually not pursued and
treatment for a presumptive viral etiology with nonsteroidal agents and steroids has been an accepted strategy. We present a patient
with pericarditis who was unresponsive to first-line therapy and was subsequently found to have necrotizing granulomas of the
pericardium with extensive adhesions and fungal elements seen on tissue biopsy. Serologic testing confirms active H. capsulatum
infection, and he responded well to Itraconazole treatment. In patients with pericarditis who fail standard therapy with NSAIDs
and steroids, it is suggested that they undergo thorough evaluation and that histoplasmosis be considered as an etiology, especially
in endemic regions.
