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Ann Thorac Surg 2003;75:1328-1330
© 2003 The Society of Thoracic Surgeons

Case report

Coccidioidal pericarditis: implications of surgical treatment in the elderly

Antonio L. Visbal, MDa, Patrick A. DeValeria, MDa*, Janis E. Blair, MDb, Matthew A. Zarka, MDc, Louis A. Lanza, MDa

a Division of Cardiovascular and Thoracic Surgery, Scottsdale, AZ, USA
b Division of Infectious Diseases, Scottsdale, AZ, USA
c Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Arizona, USA

Accepted for publication October 8, 2002.

* Address correspondence to Dr DeValeria, Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA

Coccidioidal pericarditis, an uncommonly diagnosed entity, may evolve to a constrictive process. Constrictive coccidioidal pericarditis requires pericardiectomy and antifungal therapy. In the elderly, pericardiectomy may be complicated by coagulopathy and septic shock. Despite potential toxicity, use of antifungal therapy early postoperatively offers the best chance for survival.




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