Key result
Surgical drainage and echinocandin therapy successfully treated a rare case of candida pericarditis presenting as cardiac tamponade 40 years after colonic interposition.
Case Report (n=1)
Candida pericarditis can occur as a rare, late complication decades after colonic interposition and can be successfully managed with surgical drainage and echinocandin therapy.
Alerts clinicians to rare late candida pericarditis post-colonic interposition; extends sparse case literature but leaves optimal management open.
RATIONALE: Candida pericarditis is a rare condition with high mortality. Risk factors include thoracic surgery and immunosuppression. We report a case of candida pericarditis which developed forty-years after esophageal reconstruction surgery. PATIENT CONCERNS: A 42-year-old female presented with nausea, abdominal discomfort, and chest pain, and was found to have a cardiac tamponade secondary to candida pericarditis. Her notable risk factor was colonic interposition done during her infancy for esophageal atresia. DIAGNOSES: The patient underwent emergent pericardial window where 500cc of purulent fluid was drained. The pericardial fluid culture grew Candida albicans. INTERVENTIONS: Esophagram did not show any visible leak and the patient improved with surgical drainage and antifungal treatment with Caspofungin. Caspofungin was continued intravenously for a total of four weeks and was switched to fluconazole. OUTCOMES: An Echocardiogram performed one month after pericardial window revealed trivial pericardial effusion. Serum beta-D-glucan at the time was negative. LESSONS: This report highlights that candida pericarditis infection could occur as a late complication of colonic interposition. We also demonstrate the utility of using an echinocandin in treating this entity.
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Sung et al. (2018) conducted a case report in Candida pericarditis (n=1). Surgical drainage and Caspofungin was evaluated on Clinical improvement and resolution of pericardial effusion. Surgical drainage and echinocandin therapy successfully treated a rare case of candida pericarditis presenting as cardiac tamponade 40 years after colonic interposition.
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