Listeria pericarditis as a paraneoplastic presentation

Introduction: Pericarditis is a common cause of chest pain. It has many etiologies, which are classified into infectious and non-infectious causes. The majority of cases follow a benign course. Case summary: A 66-year-old female presented with pleuritic chest pain following a febrile illness. She was diagnosed with acute idiopathic pericarditis, and standard treatment was initiated. In the following weeks she returned to the hospital multiple times due to unresolved symptoms. Pericardiocentesis was done and cultures from the fluid grew Listeria monocytogenes. CT scan uncovered metastatic pancreatic malignancy. Rapid symptom resolution was observed following the initiation of appropriate antibiotic treatment. Discussion: While most cases of pericarditis follow a benign course, the presence of high-risk features warrants a thorough investigation. In cases resistant to standard treatment, less common causes of pericarditis should be sought.