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Although Mycobacterium tuberculosis remains to be one of the most frequently identified pathogens in the pericardial fluid among people living with HIV, less commonly described etiologies include SARS‑CoV‑2 that causes coronavirus disease and human herpesvirus‑8 which is associated with Kaposi sarcoma. Isolation of more than one pathogen in normally sterile sites remains challenging and rare. We report the first documentation of both SARS‑CoV‑2 and HHV‑8 in the pericardial fluid.\nCase presentation: We present the case of a young man in his 20s with a recent history of clinically diagnosed pul‑monary tuberculosis who was admitted for progressive dyspnea and cough. He had multiple violaceous cutaneous lesions on the face, neck, and trunk and diffused lymphadenopathies. He tested positive for SARS‑CoV‑2 on admission. The patient was clinically diagnosed with pneumonia, Kaposi sarcoma, and HIV/AIDS. Empiric broad spectrum antimi‑crobial regimen was subsequently initiated. HIV with low CD4 count was confirmed during hospitalization. Echocardi‑ography revealed a large pericardial effusion, in impending cardiac tamponade. Frond‑like fibrin strands, extending to the parietal pericardium, were also observed. Pericardiostomy yielded hemorrhagic, exudative effusion with lympho‑cytic predominance. SARS‑CoV‑2 and HHV‑8 were detected in the pericardial fluid, and bacterial, fungal, and tubercu‑lous studies were negative. The patient had clinical improvement after pericardial drainage. However, despite our best clinical care, he developed a nosocomial infection leading to clinical deterioration and death.\nConclusion: Detection of SARS‑CoV‑2 and HHV‑8 in the pericardial fluid is rare, and interpretation of their signifi‑cance in clinical care is challenging. 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Detection of SARS-CoV-2 and HHV-8 from a large pericardial effusion in an HIV-positive patient with COVID-19 and clinically diagnosed Kaposi sarcoma: a case report
http://hdl.handle.net/10069/00041783
http://hdl.handle.net/10069/0004178392e5a036-00fc-4e3e-9b41-cb4e6772a365
名前 / ファイル | ライセンス | アクション |
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TMH50_72.pdf (1.5 MB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2022-10-13 | |||||
タイトル | ||||||
タイトル | Detection of SARS-CoV-2 and HHV-8 from a large pericardial effusion in an HIV-positive patient with COVID-19 and clinically diagnosed Kaposi sarcoma: a case report | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | HIV | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Kaposi sarcoma | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | HHV‑8 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | COVID‑19 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | SARS‑CoV‑2 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Tuberculosis | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Pericardial effusion | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Co‑infection | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Opportunistic infections | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Case report | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
Yanes, Ryan R.
× Yanes, Ryan R.× Malijan, Greco Mark B.× Escora-Garcia, Lyka Kymm× Ricafrente, Stephanie Angel M.× Salazar, Mary Jane× Suzuki, Shuichi× Smith, Chris× Ariyoshi, Koya× Solante, Rontgene M.× Edrada, Edna M.× Takahashi, Kensuke |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Background: Pericardial effusion is a late manifestation of HIV more commonly observed in individuals with depressed CD4 counts. Although Mycobacterium tuberculosis remains to be one of the most frequently identified pathogens in the pericardial fluid among people living with HIV, less commonly described etiologies include SARS‑CoV‑2 that causes coronavirus disease and human herpesvirus‑8 which is associated with Kaposi sarcoma. Isolation of more than one pathogen in normally sterile sites remains challenging and rare. We report the first documentation of both SARS‑CoV‑2 and HHV‑8 in the pericardial fluid. Case presentation: We present the case of a young man in his 20s with a recent history of clinically diagnosed pul‑monary tuberculosis who was admitted for progressive dyspnea and cough. He had multiple violaceous cutaneous lesions on the face, neck, and trunk and diffused lymphadenopathies. He tested positive for SARS‑CoV‑2 on admission. The patient was clinically diagnosed with pneumonia, Kaposi sarcoma, and HIV/AIDS. Empiric broad spectrum antimi‑crobial regimen was subsequently initiated. HIV with low CD4 count was confirmed during hospitalization. Echocardi‑ography revealed a large pericardial effusion, in impending cardiac tamponade. Frond‑like fibrin strands, extending to the parietal pericardium, were also observed. Pericardiostomy yielded hemorrhagic, exudative effusion with lympho‑cytic predominance. SARS‑CoV‑2 and HHV‑8 were detected in the pericardial fluid, and bacterial, fungal, and tubercu‑lous studies were negative. The patient had clinical improvement after pericardial drainage. However, despite our best clinical care, he developed a nosocomial infection leading to clinical deterioration and death. Conclusion: Detection of SARS‑CoV‑2 and HHV‑8 in the pericardial fluid is rare, and interpretation of their signifi‑cance in clinical care is challenging. However, coronavirus disease and Kaposi sarcoma must be considered and adequately addressed in immunocompromised adults presenting with large pericardial effusion. |
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書誌情報 |
Tropical Medicine and Health 巻 50, 号 1, p. 72, 発行日 2022-09-24 |
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出版者 | ||||||
出版者 | BMC | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 1349-4147 | |||||
DOI | ||||||
関連タイプ | isIdenticalTo | |||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1186/s41182-022-00464-x | |||||
権利 | ||||||
権利情報 | © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
引用 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Tropical Medicine and Health, 50(1), art. no. 72; 2022 |