Purulent pericarditis caused by candida species: Case report and review

Purulent pericarditis caused by Candidaspecies is a rare and often undiagnosed disease.Werecently treated a patient in whom purulent pericarditis due to Candida albicans developed following thoracic surgery. The patient survived after receiving a combination of surgical and medical therapy. A literature review revealed 24 additional cases of purulent pericarditis caused by Candidaspecies. Twenty-one of the patients either had undergone thoracic surgery or had had disseminated candidiasis. None of the 12 patientsdescribed before 1980 survived, whereas six (46%) of the 13 patients described after 1980survived. No patient survived without pericardiectomy (five of six survivors) or at least pericardiocentesis (one survivor). All survivors received full courses of amphotericin B therapy. An increased utilization of echocardiography, along with an increased recognition of the patient populations at risk, has been instrumental in earlydetection and improvedoutcome of purulent pericarditis. A combination of prolonged amphotericinB therapy and pericardiectomy appears to be the best approach for achieving a cure.