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Case Reports in Cardiology
Volume 2017, Article ID 3626917, 5 pages
https://doi.org/10.1155/2017/3626917
Case Report

H. capsulatum: A Not-So-Benign Cause of Pericarditis

1Department of Internal Medicine, Southern Illinois University, 751 N Rutledge, Springfield, IL 62702, USA
2Infectious Disease, Southern Illinois University, 751 N Rutledge, Springfield, IL 62702, USA
3Division of Cardiology, Southern Illinois University, 751 N Rutledge, Springfield, IL 62702, USA
4Clinical Internal Medicine, Southern Illinois University, 751 N Rutledge, Springfield, IL 62702, USA

Correspondence should be addressed to Paolo K. Soriano; ude.demuis@72onairosp

Received 17 May 2017; Accepted 24 July 2017; Published 7 September 2017

Academic Editor: Kuan-Rau Chiou

Copyright © 2017 Paolo K. Soriano et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The common causes of pericarditis and its course are benign in the majority of cases. Thus, further testing is usually not pursued and treatment for a presumptive viral etiology with nonsteroidal agents and steroids has been an accepted strategy. We present a patient with pericarditis who was unresponsive to first-line therapy and was subsequently found to have necrotizing granulomas of the pericardium with extensive adhesions and fungal elements seen on tissue biopsy. Serologic testing confirms active H. capsulatum infection, and he responded well to Itraconazole treatment. In patients with pericarditis who fail standard therapy with NSAIDs and steroids, it is suggested that they undergo thorough evaluation and that histoplasmosis be considered as an etiology, especially in endemic regions.