Kaminski Ann, Albus Michael, Mohseni Michael, Mirzan Haares, Harrison Michael F
Emergency Medicine, Mayo Clinic, Jacksonville, USA.
Internal Medicine, Mayo Clinic, Jacksonville, USA.
Cureus. 2021 Apr 10;13(4):e14397. doi: 10.7759/cureus.14397.
Pericarditis is a rare cardiac complication of coronavirus 19 (COVID-19) infection. Recent case reports describe severe sequelae of pericarditis, including cardiac tamponade, developing within days of initial COVID-19 symptoms. We present a case of pericarditis with slower onset and milder symptoms, developing over a period of a few weeks in an immunocompetent male who recovered from COVID-19 several months earlier. A 65-year-old male presented to an emergency department several times for one week of worsening chest and neck symptoms, along with fever. He had been symptom-free after a three-day course of cough, myalgias, and fever with positive COVID-19 testing, approximately 70 days earlier. He was ultimately admitted for fever and pericarditis with an associated pericardial effusion and positive PCR testing for COVID-19. Pericarditis should be considered in the differential diagnosis for patients with COVID-19 and unexplained persistent chest symptoms. The possibility of recurrent or atypical latent infection should additionally be considered in the months following the initial COVID-19 infection. Bedside ultrasound may facilitate early diagnosis and management of COVID-19 associated pericarditis.
心包炎是冠状病毒病19(COVID-19)感染罕见的心脏并发症。近期病例报告描述了心包炎的严重后遗症,包括在初次COVID-19症状出现数天内发生的心包填塞。我们报告一例心包炎病例,其起病较缓、症状较轻,在数月前从COVID-19康复的免疫功能正常男性中,历经数周逐渐出现症状。一名65岁男性因胸部和颈部症状恶化及发热一周,多次前往急诊科就诊。大约70天前,他在经历了为期三天的咳嗽、肌痛和发热且COVID-19检测呈阳性的病程后,症状消失。他最终因发热和心包炎入院,伴有心包积液,且COVID-19的PCR检测呈阳性。对于患有COVID-19且有无法解释的持续性胸部症状的患者,鉴别诊断时应考虑心包炎。在初次COVID-19感染后的数月内,还应额外考虑复发或非典型潜伏感染的可能性。床旁超声可能有助于COVID-19相关心包炎的早期诊断和管理。