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Case Reports
. 2021 Jun 23;3(10):1322-1326.
doi: 10.1016/j.jaccas.2021.04.019. eCollection 2021 Aug 18.

Pericarditis and Sacroiliitis in a World Traveler

Alessandra Vecchié  1 , Jillian E Raybould  2 , Kunal Sangal  1 , Aldo Bonaventura  1   3 , Melissa Gillen  4 , Antonio Abbate  1 , Sangeeta Sastry  2 , Hem Bhardwaj  1
Affiliations
Case Reports

Pericarditis and Sacroiliitis in a World Traveler

Alessandra Vecchié et al. JACC Case Rep. .

Abstract

A 65-year-old immunocompromised woman presented with progressive dyspnea and sacroiliac joint pain. Cardiac magnetic resonance showed abnormal right ventricular filling with septal bounce and abnormal pericardial enhancement, suggestive of constrictive pericarditis. Cultures from pericardium following pericardiectomy grew Coccidioides immitis. She was diagnosed with coccidioidomycosis and responded to pericardiectomy and amphotericin. (Level of Difficulty: Intermediate.).

Keywords: CMR, cardiac magnetic resonance; Coccidioides; IV, intravenous; LV, left ventricular; SI, sacroiliac; coccidioidomycosis; constrictive pericarditis; sacroiliitis.

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Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Radiologic Findings of Constrictive Pericarditis and Sacroiliitis (A) Cardiac magnetic resonance imaging (MRI) showing pericardial enhancement, thickening, and complex fluid along posterior lateral margin of the left ventricle. (B) Left sacroiliitis demonstrated on pelvic MRI with and without contrast.
Figure 2
Figure 2
Coccidioides immitis Growing From Left Sacroiliac Joint Culture
Figure 3
Figure 3
Pathology Findings of the Pericardium (A) Pericardium with granuloma and Coccidioides immitis endospore-filled spherule. (B) Closer view of multiple visible spherules.
See this image and copyright information in PMC

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