Sbibih Yousra, Saddari Abderrazak, Ezrari Said, Benaissa Elmostapha, Ben Lahlou Yassine, Hami Aziza, Elouennass Mostafa, Maleb Adil
Laboratory of Parasitology-Mycology, Mohammed VI University Hospital, Oujda, Morocco.
Faculty of Medicine and Pharmacy, University Mohamed First, Oujda, Morocco.
IDCases. 2025 Jan 12;39:e02151. doi: 10.1016/j.idcr.2025.e02151. eCollection 2025.
Pericardial aspergillosis is a rare but potentially fatal opportunistic infection primarily affecting immunocompromised patients. Diagnosis is challenging due to nonspecific clinical manifestations and difficulties in obtaining definitive microbiological confirmation. Risk factors include immunosuppressive therapies, hematologic malignancies, and solid organ transplantation. While pulmonary involvement is most common, cardiac manifestations such as pericarditis are infrequent and often diagnosed post-mortem. We report a case of pericarditis in a 45-year-old female with systemic lupus erythematosus on corticosteroids, presenting with dyspnea, hypotension, and pancytopenia. Diagnostic work-up revealed a large pericardial effusion with subsequent identification of in pericardial fluid cultures despite initial negative results. Prompt initiation of empirical antifungal therapy led to clinical improvement, underscoring the importance of early recognition and aggressive management in similar cases. This case highlights the complexities of managing fungal pericarditis and underscores the need for heightened clinical suspicion and tailored therapeutic approaches in immunocompromised patients.
心包曲霉病是一种罕见但可能致命的机会性感染，主要影响免疫功能低下的患者。由于临床表现不具特异性且难以获得明确的微生物学确诊，诊断颇具挑战性。危险因素包括免疫抑制治疗、血液系统恶性肿瘤和实体器官移植。虽然肺部受累最为常见，但心包炎等心脏表现并不常见，且往往在尸检时才被诊断出来。我们报告一例45岁患有系统性红斑狼疮且正在接受糖皮质激素治疗的女性心包炎病例，该患者表现为呼吸困难、低血压和全血细胞减少。诊断性检查发现大量心包积液，尽管最初结果为阴性，但随后在心包积液培养中发现了（曲霉）。及时开始经验性抗真菌治疗使临床症状得到改善，这凸显了在类似病例中早期识别和积极治疗的重要性。该病例突出了管理真菌性心包炎的复杂性，并强调在免疫功能低下患者中需要提高临床怀疑度并采用针对性的治疗方法。
