Coccidioidomycosis can rarely cause a pericarditis. The diagnosis can be challenging if the possibility of fungal pericarditis is not considered.
Involvement of the pericardium in coccidioidomycosis is uncommon. It may be:
(1) part of disseminated disease, either acute or late
(2) associated with concurrent pulmonary coccidioidomycosis
(3) as a seemingly isolated finding
Clinical presentation:
(1) fever
(2) chest pain
(3) heart failure
(4) cough
(5) dyspnea
Pericardial findings may include:
(1) pericardial effusion, including tamponade
(2) constrictive pericarditis
(3) relapsing chronic pericarditis
Diagnosis can be made:
(1) if disseminated disease has been identfiied
(2) by histologic exam of the pericardium
(3) serologic reactions with antibodies to coccidioidal antigens
(4) molecular methods
Problems in diagnosis:
(1) evaluation in a non-endemic region
(2) lack of diagnostic test availability
(3) lack of disseminated disease
(4) paucity of organisms
(5) no or limited tissue sampling
