• Joowhan Sung, Irving Enrique Perez, Addi Feinstein, and David Kidd Stein.
• Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, Bronx, NY.
• Medicine (Baltimore). 2018 Jul 1; 97 (28): e11286e11286.

RationaleCandida pericarditis is a rare condition with high mortality. Risk factors include thoracic surgery and immunosuppression. We report a case of candida pericarditis which developed forty-years after esophageal reconstruction surgery.Patient ConcernsA 42-year-old female presented with nausea, abdominal discomfort, and chest pain, and was found to have a cardiac tamponade secondary to candida pericarditis. Her notable risk factor was colonic interposition done during her infancy for esophageal atresia.DiagnosesThe patient underwent emergent pericardial window where 500cc of purulent fluid was drained. The pericardial fluid culture grew Candida albicans.InterventionsEsophagram did not show any visible leak and the patient improved with surgical drainage and antifungal treatment with Caspofungin. Caspofungin was continued intravenously for a total of four weeks and was switched to fluconazole.OutcomesAn Echocardiogram performed one month after pericardial window revealed trivial pericardial effusion. Serum beta-D-glucan at the time was negative.LessonsThis report highlights that candida pericarditis infection could occur as a late complication of colonic interposition. We also demonstrate the utility of using an echinocandin in treating this entity.

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