II. Epidemiology

  1. Fungal Pericarditis is rare

III. Causes: Immunocompetent Patients

  1. Histoplasmosis
    1. Most common Fungal Pericarditis cause in immunocompetent patients
    2. Mild cases may be treated as inflammatory Pericarditis (WITHOUT Antifungals)
  2. Blastomycosis
  3. Coccidioidomycosis

IV. Causes: Immunocompromised Patients

V. Risk Factors

  1. Immunocompromised
  2. Parenteral nutrition
  3. Prolonged antibiotics
  4. Prolonged Corticosteroids
  5. Malignancy

VI. Findings

  1. See Pericarditis
  2. Toxic appearance (typically due to associated mediastinitis)

VII. Labs

VIII. Differential Diagnosis

IX. Diagnosis

  1. Pericardiocentesis with fungal stains

X. Management

  1. See Pericarditis
  2. Consult infectious disease
  3. Intravenous Antifungals (e.g. Fluconazole, Amphotericin B)

XI. References

  1. Klasek and Alblaihed (2023) Crit Dec Emerg Med 37(6): 4-11

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