Tension pneumopericardium: an unusual manifestation of invasive pulmonary aspergillosis

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.…”

“…Despite the increased morbidity and mortality, treatment regimens are similar to those for other forms of invasive aspergillosis. All other previous cases of Aspergillus-associated pneumopericardium were treated with conventional amphotericin B therapy with mixed outcomes and prolonged hospital courses (2)(3)(4)(5). Based on the limited available data, however, voriconazole appears to have superior pericardial penetration compared with other agents, and current treatment guidelines favor this agent in the treatment of invasive aspergillosis (12)(13)(14)(15).…”

“…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.…”

Invasive Pulmonary Aspergillosis Complicated with Pneumopericardium and Pneumothorax in an Adult Patient with Acute Lymphoblastic Leukaemia, Successfully Treated with Amphotericin B: Case Report and a Review

“…However, involvement of the pleura or pericardium due to IPA is extremely rare [4]. There are only seven reported cases in the English-language literature which demonstrates the association between IPA and pneumopericardium among leukaemic patients, and the Table 1 summarizes these cases including the presenting case [3,[5][6][7][8][9][10][11][12][13]. Two more cases have also been reported which demonstrates the same clinical association, but the underlying conditions were immunodeficiency and organ transplantation [14,15].…”