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J Med Microbiol 57 (2008), 1288-1292; DOI: 10.1099/jmm.0.2008/002428-0
© 2008 Society for General Microbiology
ISSN 1473-5644

Case Report

Coccidioidal pericarditis: a rapid presumptive diagnosis by an in-house antigen confirmed by mycological and molecular methods

Raimunda S. N. Brilhante1,2,3, Rossana A. Cordeiro1,2,3,4, Marcos F. G. Rocha1,3,5, Maria A. B. Fechine1, Felipe M. Furtado1, Aparecida T. Nagao-Dias3,6, Zoilo P. Camargo7 and José J. C. Sidrim1,2,3

1 Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil

2 Postgraduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, Ceará, Brazil

3 Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, Brazil

4 Department of Biological Science, State University of Ceará, Fortaleza, Ceará, Brazil

5 Postgraduate Program in Veterinary Science, State University of Ceará, Fortaleza, Ceará, Brazil

6 Department of Clinical and Toxicological Analysis, Federal University of Ceará, Fortaleza, Ceará, Brazil

7 Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo, São Paulo, Brazil

Correspondence
Rossana A. Cordeiro
ross{at}uece.br

Received 3 April 2008
Accepted 22 May 2008

Coccidioidal pericarditis is a condition found in approximately 1–5 % of patients infected by Coccidioides species. It is associated with widely diverse clinical symptoms. This paper reports a case of coccidioidal pericarditis diagnosed by an in-house Coccidioides posadasii antigen and confirmed with mycological and molecular methods. From February to September 2005, the patient suffered from fever, weight loss, a non-productive cough, thoracic pain and tachycardia. He received a positive diagnosis of coccidioidal pericarditis only in October 2005. The macromorphological examination of the culture showed a whitish felt-like colony, which became brownish with age. Preparations in lactophenol cotton blue stain showed hyaline septate hyphae with fragmentation and thin arthroconidia-like structures. Pericardial fluid and sera samples were positive for Coccidioides antibodies by immunodiffusion and ELISA with a C. posadasii in-house antigen preparation. The C. posadasii identification was confirmed by nested PCR of the antigen 2/proline-rich antigen (Ag2/PRA) encoding gene.






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