Pericardial effusion caused by viral pericarditis in a patient receiving peritoneal dialysis

Background Acute pericarditis causes acute inflammation of the pericardium. Although most cases of pericarditis are idiopathic with no identifiable cause, its etiology can be infectious, such as viral, bacterial, mycotic, and tuberculous infections, or non-infectious, including post-pericardiotomy, metastatic malignant tumor, connective tissue disease, or uremia. However, there has been no report of pericarditis caused by adenoviral infection in patients undergoing peritoneal dialysis (PD). Herein, we report a case of pericarditis and pericardial effusion caused by adenoviral infection in a patient undergoing PD. Case presentation A 59-year-old man who had been undergoing PD in our department for 3 years had a bout of acute enteritis. He was later admitted to the emergency department of our hospital because of malaise and loss of consciousness due to pericardial effusion. Testing after admission revealed elevated adenovirus antibody titers. Pericardial effusion improved although no changes in his PD prescription were made. The patient was hospitalized and admitted to maintain hemodynamics and prevent hypotension. Since insufficient dialysis volume was ruled out by peritoneal equilibrium tests and dialysis volume assessment, the patient was kept under observation, and no changes were made regarding the method of dialysis. Pericardial effusion and the C-reactive protein level both gradually declined, and the patient's weight remained steady. The adenovirus antibody titer alone increased to 1:64 at approximately 2 weeks after hospitalization. The final diagnosis was acute pericarditis due to adenoviral infection rather than uremia or dialysis-associated pericarditis. Conclusions We treated a patient with a rare case of pericardial effusion caused by viral (adenoviral) pericarditis in a patient undergoing PD. In addition to testing for the usual causes, uremic and dialysis-associated pericarditis must always be ruled out in patients receiving dialysis. In cases of pericarditis with a viral origin, diagnosis and treatment must be comprehensive. Keywords: Peritoneal dialysis, Pericarditis, Adenovirus, Pericardial effusion, Cardiac tamponade, Pericardiocentesis, Viral infection, Hemodialysis