Acute purulent pericarditis due co-infection with <i>Staphylococcus aureus</i> and <i>Mycobacterium tuberculosis</i> as first manifestation of HIV infection

Lamas, Edgar Stroppa; Bononi, Ricardo Jose Rogoni; Bernardes, Mario Vinicius Angelete Alvarez; Pasin, Junior Luiz; Soriano, Hector Aurelio Davial; Martucci, Henrique Tavares; Valentini, Rafael

doi:10.1093/omcr/omy127

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…Nevertheless, detection of two or more pathogens in the pericardial fluid as in our case is extremely rare. Two reported cases involved M. tuberculosis–Staphylococcus aureus and M. tuberculosis–Streptococcus pneumoniae coinfections in HIV-positive patients who presented with acute purulent pericarditis and cardiac tamponade [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Detection of SARS-CoV-2 and HHV-8 from a large pericardial effusion in an HIV-positive patient with COVID-19 and clinically diagnosed Kaposi sarcoma: a case report

Yanes¹,

Malijan

Escora-Garcia³

et al. 2022

Trop Med Health

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Background Pericardial effusion is a late manifestation of HIV more commonly observed in individuals with depressed CD4 counts. Although Mycobacterium tuberculosis remains to be one of the most frequently identified pathogens in the pericardial fluid among people living with HIV, less commonly described etiologies include SARS-CoV-2 that causes coronavirus disease and human herpesvirus-8 which is associated with Kaposi sarcoma. Isolation of more than one pathogen in normally sterile sites remains challenging and rare. We report the first documentation of both SARS-CoV-2 and HHV-8 in the pericardial fluid. Case presentation We present the case of a young man in his 20s with a recent history of clinically diagnosed pulmonary tuberculosis who was admitted for progressive dyspnea and cough. He had multiple violaceous cutaneous lesions on the face, neck, and trunk and diffused lymphadenopathies. He tested positive for SARS-CoV-2 on admission. The patient was clinically diagnosed with pneumonia, Kaposi sarcoma, and HIV/AIDS. Empiric broad spectrum antimicrobial regimen was subsequently initiated. HIV with low CD4 count was confirmed during hospitalization. Echocardiography revealed a large pericardial effusion, in impending cardiac tamponade. Frond-like fibrin strands, extending to the parietal pericardium, were also observed. Pericardiostomy yielded hemorrhagic, exudative effusion with lymphocytic predominance. SARS-CoV-2 and HHV-8 were detected in the pericardial fluid, and bacterial, fungal, and tuberculous studies were negative. The patient had clinical improvement after pericardial drainage. However, despite our best clinical care, he developed a nosocomial infection leading to clinical deterioration and death. Conclusion Detection of SARS-CoV-2 and HHV-8 in the pericardial fluid is rare, and interpretation of their significance in clinical care is challenging. However, coronavirus disease and Kaposi sarcoma must be considered and adequately addressed in immunocompromised adults presenting with large pericardial effusion.

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Section: Discussionmentioning

confidence: 99%

Detection of SARS-CoV-2 and HHV-8 from a large pericardial effusion in an HIV-positive patient with COVID-19 and clinically diagnosed Kaposi sarcoma: a case report

Yanes¹,

Malijan

Escora-Garcia³

et al. 2022

Trop Med Health

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“…S. aureus is a major opportunistic pathogen that reside mainly in the respiratory tract as well as on the skin ( Tong et al, 2015 ) and can cause a wide variety of clinical manifestations, such as Methicillin-resistant S. aureus (MRSA) infection ( Hassoun et al, 2017 ) and inflammatory response in the blood ( Labandeira-Rey et al, 2007 ). Serious clinical outcomes of S. aureus co-infection with Mtb had been reported ( Manigandan et al, 2013 ; Lamas et al, 2019 ). Lamas et al reported that S. aureus was co-infected with Mtb in a clinical case of primary purulent pericarditis ( Lamas et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

“…Serious clinical outcomes of S. aureus co-infection with Mtb had been reported ( Manigandan et al, 2013 ; Lamas et al, 2019 ). Lamas et al reported that S. aureus was co-infected with Mtb in a clinical case of primary purulent pericarditis ( Lamas et al, 2019 ). Cadena et al found that the Staphylococcus genus was enriched in the Mtb-infected macaque based on 16S rRNA sequence analysis ( Cadena et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Pathogen Metagenomics Reveals Distinct Lung Microbiota Signatures Between Bacteriologically Confirmed and Negative Tuberculosis Patients

Ding

Liu

et al. 2021

Front. Cell. Infect. Microbiol.

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Understanding the dynamics of lung microbiota in tuberculosis patients, especially those who cannot be confirmed bacteriologically in clinical practice, is imperative for accurate diagnosis and effective treatment. This study aims to characterize the distinct lung microbial features between bacteriologically confirmed and negative tuberculosis patients to understand the influence of microbiota on tuberculosis patients. We collected specimens of bronchoalveolar lavage fluid from 123 tuberculosis patients. Samples were subjected to metagenomic next-generation sequencing to reveal the lung microbial signatures. By combining conventional bacterial detection and metagenomic sequencing, 101/123 (82%) tuberculosis patients were bacteriologically confirmed. In addition to Mycobacterium tuberculosis, Staphylococcus aureus, Kluyveromyces lactis, and Pyricularia pennisetigena were also enriched in the bacteriological confirmation group. In contrast, Haemophilus parainfluenzae was enriched in the bacteriologically negative group. Besides, microbial interaction exhibits a different state between bacteriologically confirmed and negative tuberculosis patients. Mycobacterium tuberculosis was confirmed correlated with clinical characteristics such as albumin and chest cavities. Our study comprehensively demonstrates the correlation between unique features of lung microbial dynamics and the clinical characteristics of tuberculosis patients, suggesting the importance of studying the pulmonary microbiome in tuberculosis disease and providing new insights for future precision diagnosis and treatment.

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“…Such avenues are clinically complicated, since affected patients can have co-infections caused by microbes belonging to different classes. For example, HIV patients can develop pericarditis in association with S. aureus and M. tb infections (Lamas et al, 2019). Similarly, myocarditis can result from coinfection with HHV-6 and parvovirus B19 (Rohayem et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

“…A variety of infectious and non-infectious triggers have been implicated in the causation of pericarditis ( (Brucato et al, 2008). The disease can also arise from co-infections caused by multiple organisms such as S. aureus and M. tb in immune-suppressive individuals as might occur in HIV infection imposing a clinical challenge to target specific pathogens for therapy particularly in patients with recurrences (Lamas et al, 2019).…”

Section: Pericarditismentioning

confidence: 99%

Triggers of Inflammatory Heart Disease

Lasrado

Yalaka

Reddy

2020

Front. Cell Dev. Biol.

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Inflammatory heart disease (IHD) is a group of diseases that includes pericarditis, myocarditis, and endocarditis. Although males appear to be more commonly affected than females, IHD can be seen in any age group. While the disease can be self-limiting leading to full recovery, affected individuals can develop chronic disease, suggesting that identification of primary triggers is critical for successful therapies. Adding to this complexity, however, is the fact that IHD can be triggered by a variety of infectious and non-infectious causes that can also occur as secondary events to primary insults. In this review, we discuss the immunological insights into the development of IHD as well as a mechanistic understanding of the disease process in animal models.

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Acute purulent pericarditis due co-infection with Staphylococcus aureus and Mycobacterium tuberculosis as first manifestation of HIV infection

Cited by 6 publications

References 16 publications

Detection of SARS-CoV-2 and HHV-8 from a large pericardial effusion in an HIV-positive patient with COVID-19 and clinically diagnosed Kaposi sarcoma: a case report

Detection of SARS-CoV-2 and HHV-8 from a large pericardial effusion in an HIV-positive patient with COVID-19 and clinically diagnosed Kaposi sarcoma: a case report

Pathogen Metagenomics Reveals Distinct Lung Microbiota Signatures Between Bacteriologically Confirmed and Negative Tuberculosis Patients

Triggers of Inflammatory Heart Disease

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