Trichinella spiralis pericarditis: An unusual cause of pericardial effusion and cardiac tamponade in an immunocompetent urban black African: a case report


 
 
 Cardiac trichinellosis is unsual and it is associated with high mortality. We report a case of Trichinella pericarditis complicated by a large pericardial effusion and cardiac tamponade in a setting where the etiologic diagnosis of pericardial disease is challenging
 
 
 
 A-27-year-old immune-competent male patient from Cameroon consulted for pleuritic chest pain associated with fever, dry cough and gradually worsening dyspnea on exertion of 1-month duration. Upon admission, his blood pressure was 100/73 mmHg, heart rate of 130/minute. Clinical examination revealed a pericardial friction rub, jugular venous distension, and tender hepatomegaly. There was no lower extremity edema. The diagnosis of pericarditis was made. A 2-dimensional transthoracic echocardiogram performed showed a moderate fibrinous circumferential pericardial effusion with echocardiographic signs of tamponade. Pericardiocentesis was performed and analysis of the fluid revealed multiple, motile, roundworms which were identified as Trichinella spiralis, a nematode parasite. There was no eosinophilia on complete blood count. He was treated with Albendazole 800 mg daily per os. His clinical condition improved with resolution of the symptoms and a reduction in the size of the pericardial effusion.
 
 
 
 Trichinella spiralis is a rare cause of pericarditis which can be life-threatening. With the existing challenges in diagnosing the etiology of pericardial disease in African resource limited setting, this the diagnosis can be missed leading to fata outcomes.
