Infect Chemother.  2012 Feb;44(1):31-34. 10.3947/ic.2012.44.1.31.

A Rare Case of Pericardial Actinomycosis

• Jung HY
• Kim HY
• Kim YK
• Kim WT
• Sung SY
• Lee JH
• Lee HS
• Hwang HW
• Cho MY
• Park IH

• KMID: 1782396
• DOI: http://doi.org/10.3947/ic.2012.44.1.31

Abstract

Actinomycosis is a common chronic suppurative and granulomatous infection caused by anaerobic or microphilic bacteria primarily from the genus Actinomyces. However, Actinomyces is a rare cause of pericarditis. We experienced a rare case of pericardial actinomycosis. A previously healthy 44-year-old man presented with 3 days of fever, chest pain, and clinical signs of congestive heart failure. Chest computed tomography showed pericardial effusion, pericardial thickening, and bilateral pleural effusion. A subxiphoidpericardiotomy was performed, and a histological specimen was taken from the pericardium. A histological section of the pericardium showed an actinomycotic granule (sulfur granule). His symptoms and signs improved after administration of piperacillin/tazobactam and steroids. He was uneventfully discharged on oral amoxicillin/clavulanate. He recovered fully with no recurrence after six months of follow-up.

Keyword

Actinomycosis; Pericarditis; Constrictive; Heart failure; Congestive

MeSH Terms

Actinomyces
Actinomycosis
Adult
Bacteria
Chest Pain
Fever
Follow-Up Studies
Heart Failure
Humans
Pericardial Effusion
Pericarditis
Pericardium
Pleural Effusion
Recurrence
Steroids
Thorax
Steroids

Figure

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  Figure 1 Chest computed tomography shows pericardial effusion, pericardial thickening, and bilateral pleural effusion.

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  Figure 2 An actinomycotic granule is embedded in the inflammatory exudates (pericardium, hematoxylin-eosin stain ×400).

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