Pericarditis is inflammation of pericardium. Pericardium is a sac like structure covering the heart. It has two layers, the outer fibrinous and the inner serous layer. The two layers are separated from each other by fluid which keeps the heart muscles moist. The pericardium keeps the heart in position when the body changes in several positions. Pericardium also reduces friction between heart and surrounding organs.
Pericarditis results from myriad of reasons such as infection, metabolic disease, post myocardial infarction, trauma, autoimmune diseases etc. Pathogens such as bacteria, virus, and fungus can infiltrate the pericardium causing infective pericarditis. Fungal pericarditis is one such form of infective pericarditis, but it is rare.
Fungal pericarditis is actually a complication of fungal infection somewhere else in the body. People with compromised immune system, patients receiving steroids for long duration or immunosuppressive therapy are vulnerable to develop this condition.Treatment consists of treating the fungal infection with anti fungal medicine.
Fungal Infections That Cause Pericarditis
Fungal pericarditis is rare as it occurs in very less number of individuals. It usually occurs among people between 20 to 50 years of age. Several species of fungus can cause fungal pericarditis. Fungus such as Candida, histoplasma, aspergillus can be the causative organisms.
Actually the patient having fungal pericarditis has fungal infection somewhere else in the body such as on skin, intestine etc. It is the primary source in most cases. The fungus then spreads to the pericardium through bloodstream or lymph channel.
Fungal pericarditis mainly develops in people who have compromised immunity. Hence a person suffering from AIDS/HIV infection, taking immunosuppressive drugs, transplant patients, people with low white blood cells count, cancer patients taking chemotherapy etc. are at risk of developing fungal infection and fungal pericarditis. The risk also increases if there is previous history of acute pericarditis.
Signs And Symptoms Of Fungal Pericarditis
Following are the signs and symptoms of fungal pericarditis. The signs and symptoms are usually similar to other forms of pericarditis.
- Mild or moderate fever with or without chills.
- Chest pain which may exaggerate on coughing or sneezing. It is sharp and stitching in nature. Pain may radiate on the back, left shoulder, and epigastrium region.
- It is associated with dry cough.
- Patient has severe fatigue and tiredness.
- Palpitation and rapid pulse.
- Difficulty in breathing especially while lying down.
- Chest pain is aggravated while lying down and relieved by sitting up.
- Edema in legs and feet.
- There may be fungal infection on some other site such as on skin etc.
Treatment For Fungal Pericarditis
Fungal pericarditis is serious disease having increased rate of mortality if the condition is untreated. Treatment consists of curing the underlying fungal infection or the source of fungal infection. For example fungal infection on skin must be addressed if that is the primary source. However, treatment remains the same—broad spectrum anti-fungal medicines that will kill the stubborn fungi. In many cases pain killers may be needed to relieve pain.
Patient needs to take rest as this will help the body regain strength. If there is excessive build up fluid inside the pericardium, it may require to be aspirated. It may help to relieve breathing difficulty, and pain. The procedure followed is called pericardiocentesis. Patient can have full recovery if the disease is detected and treated early.