What are the other Names for this Condition? (Also known as/Synonyms)

• Fungal Pericardial Inflammation

What is Fungal Pericarditis? (Definition/Background Information)

• Pericarditis refers to swelling and inflammation of the pericardium, a sac-like layer that covers the heart. The pericardium contains a fluid that keeps the heart muscle moist and ensures a smooth function
• When this sac becomes inflamed due to an underlying fungal infection, the resulting friction between the membrane and muscle causes a stabbing chest pain, and results in Fungal Pericarditis
• The actual site of infection origin may be in another area of the body, as a result of which complications can arise and cause infection in the pericardium. In general, pericarditis can also be caused by a viral infection, autoimmune disorder, and other factors
• The treatment of Fungal Pericarditis primarily involves treating the underlying fungal infection. The prognosis depends on many factors, although in most cases with appropriate treatment, it is good
• Fungal Pericarditis, in some cases, can become a chronic issue. However, in a majority of the individuals the condition is generally short-lived

Who gets Fungal Pericarditis? (Age and Sex Distribution)

• Fungal Pericarditis is a rare condition that is more often seen in individuals in the 20-50 year age group
• Both males and females are affected by the infection, though the condition is more common in males
• No racial, ethnic, or geographical preferences are seen

What are the Risk Factors for Fungal Pericarditis? (Predisposing Factors)

Fungal Pericarditis risk factors include the following:

• A previous diagnosis of acute pericarditis may increase the risk for Fungal Pericarditis
• If the immune system is already weakened due to HIV, cancer, or any other such conditions, then the possibility of the infection is higher

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Fungal Pericarditis? (Etiology)

Fungal Pericarditis may be caused by any of the following species of fungi:

• Histoplasma sp. (most common cause of Fungal Pericarditis)
• Aspergillus sp.
• Candida sp.
• Coccidioides immitis

Pericarditis may also occur due to other organisms such as a virus or bacteria. Sometimes, an underlying disorder (like an autoimmune disorder) may cause inflammation of the pericardium. In majority of the cases, the cause of pericarditis remains unidentified (idiopathic pericarditis).

What are the Signs and Symptoms of Fungal Pericarditis?

The signs and symptoms of Fungal Pericarditis include, but are not limited to, the following:

• Low-grade fever, chills, sweating
• Chest pain; pain in chest increases on coughing or swallowing
• Dry cough
• Fatigue, anxiety
• Difficulty breathing, which gets worse especially while reclining or lying down, but gets better on sitting, leaning forward or standing
• Rapid heart rate, heart palpitations
• Pain in the back
• Swelling of the legs and feet (edema)
• Signs and symptoms of the underlying infection

How is Fungal Pericarditis Diagnosed?

A diagnosis of Fungal Pericarditis may be made as follows:

• A thorough physical examination with a complete medical history
• If symptoms are noted, the healthcare provider may need a full medical history to correlate the condition and rule out other possible causes of infection
• A stethoscope is used to listen to the heartbeat; if a faint sound is heard, it can usually raise suspicion/concern for the healthcare provider

A series of tests to view structures and fluid present in the heart may then be ordered, for further observation of the infection. These tests may include:

• Blood culture to determine the causative organism, if bacterial or fungal infection is suspected
• X-ray of chest
• CT or MRI scan of the chest
• Echocardiogram

The radiology imaging tests may show the presence of any abnormal fluid levels around the heart, within the pericardial sac.

• Sometimes, depending on the clinical situation, abnormal fluid in the pericardial sac may be cultured, to show which specific fungal organism is responsible for the infection
• The fluid is collected by aspiration through a procedure called pericardiocentisis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Fungal Pericarditis?

The following complications may occur due to Fungal Pericarditis:

• Constrictive pericarditis, a condition wherein the heart function is restricted, due to compression by the surrounding pericardial sac
• Swelling of the lungs (pulmonary edema)
• Cardiac tamponade (accumulation of excess fluid)
• Shock: A condition which can result in failure of vital organs in the body
• The condition may recur (recurrent pericarditis) or last for many years (chronic pericarditis)

How is Fungal Pericarditis Treated?

The underlying fungal infection must be treated, in order to effectively control and cure pericarditis. The treatment of Fungal Pericarditis may include the following measures:

• The use of medications to kill virus and manage pain such as:
  • Analgesics (to relieve pain)
  • Antifungal medication (to kill the fungi)
  • Anti-inflammatory medication (to decrease inflammation)
• Plenty of rest (bed rest) will be recommended as well
• If there is a severe buildup of fluid, a small cut is made in the pericardium, to allow drainage of the fluid. This procedure is called pericardiocentesis
• Additionally, diuretics to help decrease excess fluid accumulation in the body, may be administered
• The treatment for recurrent pericarditis (arising from acute pericarditis) is using colchicine medication

How can Fungal Pericarditis be Prevented?

A few preventative tips for Fungal Pericarditis may include:

• Maintaining a healthy lifestyle and diet can help minimize the chances of contracting fungal infections
• Ensure that open wounds/cuts are cleaned and covered, to prevent fungus from entering the body
• If an individual has a weakened immune system, then appropriate treatment to boost the immune system can help prevent Fungal Pericarditis

What is the Prognosis of Fungal Pericarditis? (Outcomes/Resolutions)

• Fungal Pericarditis can lead to life-threatening symptoms, if the condition is left untreated
• If the infection is diagnosed early and treated effectively, the affected individuals typically make a full recovery

Additional and Relevant Useful Information for Fungal Pericarditis:

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/common-procedures/procedures-laboratory/pericardial-fluid-analysis/