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免疫功能正常个体中足菌肿导致渗出性缩窄性心包炎：罕见病例

Mycetoma Leading to Effusive Constrictive Pericarditis in an Immunocompetent Individual: A Rare Encounter.

作者信息

Rivera-Martinez Juan C, Owen Philip S, Baddoura Sami, Hassan Mohammed

机构信息

Internal Medicine, Lakeland Regional Health Medical Center, Lakeland, USA.

Cardiology, Lakeland Regional Health Medical Center, Lakeland, USA.

出版信息

Cureus. 2024 Nov 8;16(11):e73287. doi: 10.7759/cureus.73287. eCollection 2024 Nov.

DOI:10.7759/cureus.73287
PMID:39655143
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11626487/
Abstract

Nocardial infections are rare but serious, often leading to systemic and cardiopulmonary complications. This is the first reported case of  causing constrictive pericarditis in an immunocompetent individual. We present a 37-year-old Caucasian female patient with no significant medical history who developed pericarditis symptoms after handling crates from China. Despite initial treatment for presumed viral pericarditis, her condition worsened. Further investigation identified  as the cause of effusive constrictive pericarditis. The patient underwent a pericardiectomy, which resolved her symptoms. This case demonstrates the need to consider rare pathogens in cases of refractory pericarditis, regardless of the patient's immune status. Clinicians should maintain a high level of suspicion for uncommon infections in progressively worsening cases and adopt a multidisciplinary diagnostic approach for timely intervention.

摘要

诺卡菌感染虽罕见但严重，常导致全身及心肺并发症。这是首例报道的在免疫功能正常个体中引起缩窄性心包炎的病例。我们报告一名37岁无显著病史的白种女性患者，她在处理来自中国的板条箱后出现心包炎症状。尽管最初按疑似病毒性心包炎进行治疗，但其病情仍恶化。进一步检查确定 为渗出性缩窄性心包炎的病因。患者接受了心包切除术，症状得以缓解。该病例表明，无论患者免疫状态如何，在难治性心包炎病例中都需要考虑罕见病原体。临床医生对病情逐渐恶化的病例中不常见感染应保持高度怀疑，并采用多学科诊断方法以便及时干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/6b28be2a4edc/cureus-0016-00000073287-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/852800e27ff8/cureus-0016-00000073287-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/4e986a5bb9d9/cureus-0016-00000073287-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/b5bb65dcb532/cureus-0016-00000073287-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/d5be848c7d38/cureus-0016-00000073287-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/4b90ace98c09/cureus-0016-00000073287-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/658e324c6c99/cureus-0016-00000073287-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/14263678c0a0/cureus-0016-00000073287-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/347c0fbe6aa7/cureus-0016-00000073287-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/6b28be2a4edc/cureus-0016-00000073287-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/852800e27ff8/cureus-0016-00000073287-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/4e986a5bb9d9/cureus-0016-00000073287-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/b5bb65dcb532/cureus-0016-00000073287-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/d5be848c7d38/cureus-0016-00000073287-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/4b90ace98c09/cureus-0016-00000073287-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/658e324c6c99/cureus-0016-00000073287-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/14263678c0a0/cureus-0016-00000073287-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/347c0fbe6aa7/cureus-0016-00000073287-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a3c/11626487/6b28be2a4edc/cureus-0016-00000073287-i09.jpg

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