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November 1963

Probable Histoplasma Pericarditis With EffusionReport of a Case With Recurrence

Arch Intern Med. 1963;112(5):652-660. doi:10.1001/archinte.1963.03860050066005

As Histoplasma capsulatum is capable of systemic dissemination, disease due to this agent may have protean manifestations including cardiovascular involvement. Such involvement has been reported as follows: pericardial calcification,1-3 fibrocalcific pericarditis with constriction,4 superior vena caval obstruction,5 endocarditis,6 electrocardiographic evidence of pericarditis with positive histoplasmin skin test,7 and at least six cases of acute pericarditis with effusion.5,8-12 The present report adds another case of acute pericarditis with effusion and recurrence probably due to H capsulatum.

Report of Case  A 17-year-old white man entered the University of Illinois Research and Educational Hospitals on April 8, 1960. On March 25 and March 26, I960, he had noted a mild sore throat without constitutional symptoms. At 5 am on March 27 he awakened with "sharp, tight" anterior chest pain accompanied by dyspnea and diaphoresis. After emergency admission to another hospital, he was treated with methylprednisolone, 4 mg t.i.d., symptomatic drugs for pain, and bed

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