Program Schedule

1460
Disseminated Pericardial coccidioidomycosis:  A Case Series and Review of the Literature

Session: Poster Abstract Session: Fungal Infections
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • Poster - Cocci Pericarditis.pdf (1.4 MB)
  • Background: Extra pulmonary manifestations of coccidioidomycosis have been reported to have an incidence of 4.7% of recognized and 0.2% of total infections. Among these cardiac disease and especially pericardial dissemination has not been well reported in the literature. Five cases of pericardial disease with coccidioidomycosis at Kern Medical Center are described.

    Methods: We queried Kern Medical Center database of 1771 patients with coccidioidomycosis spanning between the years 1992 and 2014. Cases were selected based on an Institutional Review Board approved chart review.

    Results: Five cases were encountered. Of the five, four were African American, one was Filipino. The average age was 30.2 ranging from 23 to 52. All patients were male. Three were oil field workers. Tachycardia was present in all cases. The Complement Fixation titers ranged between 1:32 to >1:512 upon presentation. Echocardiography was performed on all which showed ejection fraction ranging between 30% to 75%. Two cases had moderate to large pericardial effusions and both underwent pericardial window placement. Cultures from pericardial fluid were negative. Three cases had constrictive pericarditis of which two underwent pericardiectomy, with one postoperative mortality. Other case was treated medically. Medical treatment on all cases was initiated with lipid preparation of amphotericin B with average duration of 16 weeks followed by azole therapy mainly with posaconazole.

    Conclusion: Pericardial coccidioidomycosisis a serious form of dissemination with significant risk of morbidity and mortality and requires aggressive multidisciplinary approach and treatment. African American ethnicity and male sex are possible risk factors.

    Arash Heidari, M.D.1, Avi Cohen, M.D.2 and Royce H. Johnson, M.D., F.A.C.P.1, (1)Infectious Diseases, Kern Medical Center/UCLA, Bakersfield, CA, (2)Department of Medicine, Kern Medical Center/UCLA, Bakersfield, CA

    Disclosures:

    A. Heidari, None

    A. Cohen, None

    R. H. Johnson, Astellas Pharma US: Speaker's Bureau, Speaker honorarium
    Forest Phamaceuticals: Speaker's Bureau, Speaker honorarium
    Pfizer Inc: Investigator, Research support
    Chevron: Grant Investigator, Grant recipient

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