Wheat L J, Stein L, Corya B C, Wass J L, Norton J A, Grider K, Slama T G, French M L, Kohler R B
Medicine (Baltimore). 1983 Mar;62(2):110-9. doi: 10.1097/00005792-198303000-00004.
During two histoplasmosis outbreaks in Indianapolis 45 patients presented with pericarditis. The pericarditis occurred as a late complication in individual patients and during the outbreak. Risk factors for this complication included young age, immunocompetence, and male sex in persons between 20 and 39 years old. Intrathoracic adenopathy was present in 66% of cases. Since cultures were uniformly negative, including pericardial fluid or tissue from nine patients, serologic studies provided the basis for diagnosis. Although the course was usually benign, nine patients presented with tamponade and another with constrictive pericarditis. Prompt response to antiinflammatory medications and failure to identify H. capsulatum in the pericardial fluid or tissue support a noninfectious, inflammatory mechanism for this complication. Of 20 patients reexamined 1 year later, none had evidence of constriction but three had pericardial thickening by echocardiography. Histoplasmosis should be considered in patients with pericarditis from endemic areas, particularly when associated with intrathoracic adenopathy.
在印第安纳波利斯的两次组织胞浆菌病暴发期间，有45例患者出现心包炎。心包炎在个别患者中作为晚期并发症出现，也在暴发期间出现。该并发症的危险因素包括20至39岁人群中的年轻、免疫功能正常和男性性别。66%的病例存在胸内淋巴结肿大。由于包括9例患者的心包液或组织在内的培养结果均为阴性，血清学研究为诊断提供了依据。尽管病程通常为良性，但9例患者出现心包填塞，另1例出现缩窄性心包炎。对抗炎药物的迅速反应以及在心包液或组织中未能鉴定出荚膜组织胞浆菌，支持了该并发症的非感染性炎症机制。在1年后重新检查的20例患者中，没有一例有缩窄的证据，但有3例经超声心动图检查有心包增厚。来自流行地区的心包炎患者应考虑组织胞浆菌病，特别是当伴有胸内淋巴结肿大时。
