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August 1968

Acute Histoplasma Pericarditis

Arch Intern Med. 1968;122(2):162-166. doi:10.1001/archinte.1968.00300070066013

The varied manifestations of histoplasmosis have been emphasized in recent years.1,2 Involvement of the heart has been reported infrequently, although Histoplasma capsulatum can invade the endocardium, myocardium, or pericardium, as recently reviewed.3 Asymptomatic pericarditis, presumably due to Histoplasma organisms and manifested by electrocardiographic changes 4 or by calcification and a positive histoplasmin skin test,5,6 has been observed in four individuals. Histoplasma may also produce constrictive pericarditis.7-11 Only 14 instances of acute pericarditis presumably due to H capsulatum have appeared in the literature.3,10,12-20

The following two patients with acute pericarditis with effusion, presumably due to H capsulatum, are described for two reasons: first, to report a relatively rare manifestation of histoplasmosis, and second, to emphasize the importance of suspecting this fungus in each instance of pericardial disease.

Patient Summaries 

Patient 1.  —A 39-year-old white male officer was admitted to the Wright-Patterson Air Force Hospital on March

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