Pneumopericardium complicating invasive pulmonary aspergillosis: Case report and review

Abstract

Pneumopericardium, the presence of air in the pericardial space, is a rare disorder that is usually caused by trauma. We describe a patient given induction chemotherapy for acute myelogenous leukemia who developed pulmonary aspergillosis that resulted in pericarditis and pneumopericardium. He responded to antifungal treatment and recovered from granulocytopenia, but died early during the next course of chemotherapy. Two other reported cases of pneumopericardium associated with pulmonary aspergillosis are summarized.

Myocardial Infarction Caused by Aspergillus Embolization in a Patient with Aplastic Anemia

“…, and Aspergillus pericarditis and myocarditis have also been described in some papers (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). In this report, we describe a case in an aplastic anemia patient with fungal occlusion of the coronary arteries and fungal invasion of the pericardium and myocardium, although he had been receiving treatment with amphotericin B.…”

“…(6)(7)(8)(9)(10), endocarditis (7,(18)(19)(20)(21)(22), pericarditis (7,8,(10)(11)(12)(13)(14)(15)(16)(17), pericardial tamponade (11,13,16), superior vena cava syndrome (23), aortitis (24), intracardiac mass (25) and atrioventricular block (9). (6,11,12,16,27).…”

Acute Lymphocytic Leukemia with Superimposed Invasive Aspergillosis and Pneumopericardium Successfully Treated with Voriconazole

“…Th e introduction of air into the pericardial space secondary to a fungal infection is extremely rare. Th e Table summarizes the fi ve known cases (including the present report) of invasive aspergillosis complicated by pneumopericardium (2)(3)(4)(5). All cases involved men with prior histories of leukemia, with similar clinical presentations of chest pain and dyspnea.…”

“…Th e prognosis of patients infected with Aspergillus with pericardial involvement is generally very poor (2,4). Despite the increased morbidity and mortality, treatment regimens are similar to those for other forms of invasive aspergillosis.…”

“…A spergillus pericarditis is a rare clinical entity but is associated with potentially life-threatening complications that pose signifi cant medical and surgical challenges to eff ective management (1)(2)(3)(4)(5). Th is case describes a case of Aspergillus pericarditis in a patient with leukemia.…”