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Case Reports in Cardiology
Volume 2017, Article ID 7134586, 3 pages
https://doi.org/10.1155/2017/7134586
Case Report

Aspergillus Pericarditis with Tamponade in a Renal Transplant Patient

Albert Einstein Medical Center, 5501 Old York Road, Philadelphia, PA 19141, USA

Correspondence should be addressed to Sylvia Biso; ude.nietsnie@vlysosib

Received 13 October 2016; Accepted 2 February 2017; Published 20 February 2017

Academic Editor: Expedito E. Ribeiro

Copyright © 2017 Sylvia Biso 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

Aspergillus pericarditis is a rare and life-threatening infection in immunosuppressed patients. It has nonspecific clinical manifestations that often mimic other disease entities especially in patients who have extensive comorbidities. Diagnosis is oftentimes delayed and rarely done antemortem. A high degree of suspicion in immunocompromised patients is necessary for evaluation and timely diagnosis. This is a case of Aspergillus pericarditis with cardiac tamponade in a renal transplant patient with liver cirrhosis. Two months after transplant, he developed decompensation of his cirrhosis from hepatitis C, acute cellular rejection, and Kluyvera bacteremia, followed by vancomycin-resistant Enterococcus faecium (VRE) bacteremia. Four months after transplant, the patient presented with lethargy and fluid overload. He subsequently developed shock and ventilator-dependent respiratory failure. An echocardiogram showed pericardial effusion with cardiac tamponade. He had emergent pericardiocentesis that showed purulent drainage. He was started on broad-spectrum antibiotics. Amphotericin B was initiated when the pericardial fluid grew mold that was later identified as Aspergillus fumigatus. The patient quickly decompensated and expired.