Table 1 Characteristics of patients with amebic pericarditis

1

Laha [6]

17

F

India

Fever for 2 days

N/A

N/A

Yes, R

The response to treatment

N/A

Pericardiocentesis

Emetine 3 g

Cure

N/A

2

Berberian [7]

59

M

The United States

Malaise, weakness, diarrhea

N/A

N/A

No

Biopsy of the wall of the umbilical sinus was positive for E. hystolytica

N/A

N/A

Aureomycin

Died

N/A

3

Beemer [8]

27

M

Canada

Left sided chest pain

N/A

N/A

Yes, L

Autopsy

N/A

N/A

Streptomycin, isoniazid

Died

N/A

4

Downie [9]

2

M

Nigeria

Cough, discharging ears, vomiting and diarrhea

None

None

Yes, L

Amoeba was seen in the connective tissue outside the pericardium.

The pericardial surface of the heart was covered by thick fibrin

N/A

N/A

Died

N/A

5

Paulley [5]

51

M

United Kingdom

Burning precordial pain

Ischemic infarction

Residence in India 20 years before admission

Yes, L

The response to treatment

N/A

None

Penicillin, chloramphenicol, chloroquine, emetine

Cure

N/A

6

Mullan [10]

73

M

United Kingdom

Upper abdominal pain, anorexia, hemoptysis over 1 month

N/A

Residence in Mesopotamia 50 years before admission

Yes, R

The presence of confirmed amebic liver abscess and the response to treatment

None (Liver: Actively motile amoebae,containing red cells, were present)

Pericardiocentesis

Emetine

Died

None

7

Gelfand [11]

12

M

Zimbabwe

Right chest pain for 3 weeks, shortness of breath, weight loss, and fever

None

None

Yes,

Bloodstained fluid, and the response to treatment

Dense fibrous tissue with a sparse chronic inflammatory cellular infiltrate and with a small part of its surface covered by a narrow zone of granulation tissue

Pericardiocentesis

Emetine

Cure

N/A

8

Kulpati [12]

23

M

India

Prexia, upper abdominal pain, constipation

N/A

N/A

Yes

Liver aspiration contained trophozoites of E. histolytica

N/A

N/A

Yes, but not mentioned in detail

Cure

No recurrence 4 month after discharge

9

D’cruz [13]

21

M

India

Severe retrosternal pain, vomited and fainted

N/A

N/A

Yes

Pericardial fluid contained trophozoites of E. histolytica

N/A

None

No

Died

N/A

10

Rab [14]

49

M

Pakistan

Retrosternal pain, dyspnea

N/A

N/A

Yes, L

Anchovy sauce pus and the response to treatment

Fibrinous deposit

Pericardiocentesis

N/A

Died

None

11

Cook [15]

25

M

Malaysia

Fever, cough, bloody sputum

None

N/A

Yes, R

The response toemetine and a strongly positive amebic fluorescent antibody test

None

Pericardiocentesis, laparotomy of left subphrenic abscess

Emetine and chloroquine

Cure

N/A

12

Ganeshananthan [16]

36

M

Sri Lanka

Dry cough and chest pain for 3 weeks

N/A

N/A

N/A

Thick brown pus, having the consistency of typical amoebic liver abscess pus

N/A

Pericardiocentesis

Emetine, metronidazole, chloroquine

Cure

No recurrence 3 years after discharge

13

Bansal [17]

19

M

India

Fever, dry cough, right shoulder pain for 5 days

N/A

N/A

Yes, R

Anchovy sauce pus and the response to treatment

None

Pericardiocentesis

Emetine, chloroquine, di-iodohydroxy quinoline

Cure

No recurrence 16 months after discharge

14

Kapoor [18]

27

M

India

High fever with pain in the left chest and subcostal region

Gastro-pericardial fistula

N/A

Yes, L

N/A (Stool: trophozoites of E. histolytica)

N/A

Pericardiocentesis

Intramuscular emetine

Cure

NA

15

Kapoor [18]

30

M

India

General weakness, pain in the abdomen and swelling in the epigastrium for 3 weeks

N/A

N/A

Yes, L

N/A (Stool: trophozoites of E. histolytica)

N/A

Pericardiocentesis

Emetine, chloroquine

Cure

N/A

16

Kapoor [18]

34

M

India

Pain in the epigastrium and right lumber region for 2 months

N/A

N/A

Yes

Anchovy sauce pus from the front of pericardial cavity

N/A

Pericardiocentesis, thoracotomy

Emetine

Cured

N/A

17

Kapoor [18]

35

M

India

Sudden onset of severe generalized chest pain and dyspnea for 12 h

N/A

N/A

Yes, L

N/A (Liver: trophozoites of E. hystolytica)

Yes

Pericardiocentesis

N/A

Died

N/A

18

Kapoor [18]

25

M

India

Pyrexia for 5 days

N/A

N/A

N/A

N/A

N/A

Pericardiocentesis

Dehydroemetine, chloroquine

Cured

No recurrence 3 weeks after discharge

19

Kapoor [18]

50

M

India

Fever for 2 months and pain in the right hypochonrium

N/A

N/A

Yes, L

Anchovy sauce pus from the pericardial cavity

N/A

Pericardiocentesis

Emetine, chloroquine

Cured

No recurrence two years after discharge

20

Spiegel [19]

48

M

The United States

Abdominal pain of right upper quadrant

N/A

N/A

Yes, R

Pericardial fluid contained trophozoites of E. histolytica

N/A

N/A

Metronidazole and chloroquine

Cure

N/A

21

Heller [20]

42

F

United States

Dyspnea, weight loss, left upper abdominal pain for 8 days

N/A

Move from Mississippi to Chicago when she was 3 years old

Yes, L

Anchovy sauce pus, the response to treatment, and indirect hemagglutination test (1:2560)

Fibrinous pericarditis

Pericardiocentesis followed by pericardiectomy

Metronidazole 750 mg thrice daily for 3 weeks

Cure

N/A

22

Heller [20]

47

M

United States

Retrosternal pain, sweating, dyspnea for 1 day

N/A

Move from Mexico to Chicago 5 months previously

Yes, L

Anchovy sauce pus, the response to treatment, and indirect hemagglutination test (1:5128)

Fibrinous pericarditis

Pericardiectomy

Emetine (next day changed to dehydroemetine), chloroquine

Died

None

23

Anderson [21]

N/A

M

United States

Left pleuritic chest pain, jaundice for 10 days

None

N/A

Yes, L

Anchovy sauce pus and the response to treatment

None

Pericardiocentesis followed by pericardiectomy

N/A

Cure

N/A

24

Suryanarayan [22]

40

M

India

Pain in the epigasric region and hypochondrium for one mouth, and dysponea for 1 week

N/A

N/A

Yes, L

N/A

N/A

Pericardiocentesis

Dehydroemetine, tetracyclines, chloroquine and didoquin

Cure

N/A

25

Suryanarayan [22]

45

M

India

Fever for 3 months and dyspnea for 2 days

N/A

N/A

Yes, L

Pericardial fluid contained trophozoites of E. histolytica

N/A

None

N/A

Died

N/A

26

Lewis [23]

35

M

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

27

Ganeshananthan [16]

33

M

Sri Lanka

Left-sided chest pain and shortness of breath for 2 weeks

N/A

N/A

N/A

The fluorescent antibody test was positive

N/A

Pericardiocentesis

Emetine, metronidazole

Cure

No recurrence 6 months after discharge

28

Ganeshananthan [16]

43

M

Sri Lanka

Shortness of breath and pain in the chest and abdomen for 18 days

N/A

N/A

Yes

Typical amoebic pus was drawn out from needling of the pericardium

N/A

Pericardiocentesis

Emetine, tetracycline, metronidazole

Cure

N/A

29

Ganeshananthan [16]

32

 N/A

Sri Lanka

Pain in the left upper abdomen for 2 months

N/A

N/A

N/A

The fluorescent antibody test was positive

N/A

Pericardiocentesis

Emetine and chloroquine followed by metronidazole

Cure

N/A

30

Guimaraes [24]

33

M

Brazil

Fever, chills, dry cough, retrosternal pain, weight loss, dyspnea, diarrhea

N/A

N/A

Yes, L

Anchovy sauce pus and the response to treatment

N/A

Pericardiocentesis

Chloroquine 2 g daily for 7 days, followed by 500 mg daily for 23 days, metronidazole 2 g daily for 30 days, emetine hydroxychloroquine 60 mg daily for 10 days plus the injection of 75% hypaque into the pericardial cavity

Cure

N/A

31

Faerber [25]

35

M

South Africa

Pleuritic chest pain, productive cough, hemoptysis for 2 months

N/A

N/A

Yes, R and L

N/A

N/A

N/A

N/A

Cure

N/A

32

Haranath [26]

55

M

India

Exertional dyspnea, distention of the abdomen and edema of the left upper limb for 10 days

Rheumatic fever

N/A

N/A

Anchovy sauce pus from the cardiac cavity

N/A

Pericardiocentesis

Dehydroemetine, metronidazole

Cure

NA

33

Ganesan [3]

40

M

India

Progressive general weakness, chest pain, dyspnea for 20 days

N/A

N/A

Yes, L

Anchovy sauce pus and the response to treatment

None

Pericardiocentesis

Dehydromethine 30 mg daily for 10 days, chloroquine 250 mg thrice daily for 10 days, and metronidazole 1200 mg daily for ten days

Cure

N/A

34

Agrawal [1]

40

M

India

Fever, cough, pain in right hypochondrium, fatigue for 2 months

None

N/A

Yes, L

Aspiration of anchovy source pus from the cardiac cavity

The nonspecific chronic inflammatory reaction of the pericardium

Pericardiocentesis

Metronidazole 400 mg thrice daily

Died

None

35

Agrawal [1]

25

 N/A

India

Pain in the upper abdomen and dry cough for 2 weeks

None

N/A

Yes, L

Aspiration of anchovy source pus from the cardiac cavity

An actively inflamed fibrosing pyopericardium of nonspecific nature

Pericardiocentesis

Metronidazole 400 mg thrice daily

Cure

No recurrence 6 months after discharge

36

Kulpati [27]

34

M

India

Moderately high intermittent fever and dull aching pain in right hypochondrium for 1 month

History of amoebic dysentery about 8 months back

N/A

Yes, L

The pericardial fluid was chocolate colored. The direct smear and culture of pericardial fluid demonstrated E. hystolytica

N/A

Pericardiocentesis

Metronidazole and emetine

Died

N/A

37–63

Adams EB1-27 [28]

N/A

N/A

South Africa

N/A

N/A

N/A

8 patients (mostly L)

N/A

N/A

N/A

N/A

Cure (n = 19) Died (n = 8)

N/A

64

Muralidar [29]

19

F

India

Pyrexia and pain in the right upper abodomen for 2 weeks and breathlessness for 4 days

None

N/A

N/A

Anchovy sauce pus from the cardiac cavity

N/A

Pericardiocentesis

Emetine, metronidazole, and tetracycline

Died

N/A

65

Muralidar [29]

52

M

India

Chest pain and breathlessness since 3 days

History of amoebic dysentery

N/A

N/A

Anchovy sauce pus from the cardiac cavity, serum indirect hemagglutination

N/A

Pericardiocentesis

Emetine and metronidazole

Cure

No recurrence 6 weeks after discharge

66

Kundu [30]

25

F

India

Pain in right hypochondrium associated with moderately high intermittent fever for 15 days and difficulty in breathing for 1 week

None

N/A

Yes, L

Serum gel diffusion test, chocolate pus

N/A

Pericardiocentesis

Metronidazole followed by chloroquine

Cure

No recurrence 4.5 months after discharge

67

Bellosillo [31]

37

M

Philippine

Shortness of breath

N/A

N/A

Yes

Pericardial fluid contained trophozoites of E. histolytica

N/A

Pericardiocentesis

Tinidazole

Cure

No recurrence 3 months after discharge

68–72

Verghese 1-5 [32]

N/A

N/A

India

N/A

N/A

N/A

N/A

N/A

N/A

Pericardiocentesis (n = 1), pericardiotomy (n = 3)

N/A

Cure (n = 3) Died (n = 2)

N/A

73

Almeida [33]

35

M

India

Epigastric pain for 1 month and swelling in upper abdomen for 15 days

None

N/A

Yes, L

Anchovy sauce pus and the response to treatment

N/A

Pericardiocentesis

Emetine and chloroquine

Cure

No recurrence 9 months after discharge

74

Almeida [33]

20

M

India

Shortness of breath and left chest pain for 3 days

None

N/A

Yes, L

Anchovy sauce pus from the cardiac cavity

Pericardium was thickened

Pericardiocentesis

Emetine, and oxytetracycline

Died

N/A

75

Almeida [33]

25

M

India

Left chest pain, cough, and fever for 1 month

None

N/A

Yes, L

Anchovy sauce pus from the cardiac cavity

N/A

Pericardiocentesis

N/A

Died

N/A

76

Almeida [33]

40

M

India

Anorexia, fever, and right chest pain for 15 days

None

N/A

Yes, L

N/A

Autopsy revealed liver abscess with pericarditis and cardiac tamponade

None

N/A

Died

N/A

77

Almeida [33]

50

F

India

Jaundice and fever for 1 month

None

N/A

Yes, L

Bloodstained fluid

N/A

Pericardiotomy

Emetine and metronidazole

Died

N/A

78–89

Tyagi 1–12 [34]

4–55

M:9 F:3

India

Fever (n = 10), dyspnea (n = 5), cough (n = 4), diarrhea (n = 3

 N/A

N/A

Yes, L: 5, R: 4

Anchovy sauce pus from the cardiac cavity (n = 2), pericardial fluid contained trophozoites of E. histolytica (n = 2)

N/A

Pericardiocentesis

N/A

Cure (n = 4) Died (n = 8)

N/A

90

Gupta [35]

43

M

India

Dyspnea, chest pain

N/A

N/A

No

Pericardial fluid contained trophozoites of E. histolyticaAutopsy

N/A

Pericardiocentesis

N/A

Cure

N/A

91

Kala [36]

35

M

India

Dyspnea, diarrhea

N/A

N/A

Yes

Pericardial fluid contained trophozoites of E. histolyticaAutopsy

N/A

Pericardiocentesis followed by pericardiectomy

Emetine, Streptomycin, isoniazid

Cure

N/A

92–101

Ibarra-Perez 1–10 [37]

N/A

N/A

Mexico

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

102

Adeyemo [38]

N/A

N/A

Nigeria

N/A

N/A

N/A

Yes, L

N/A

N/A

Pericardiocentesis

N/A

Died

N/A

103

Adeyemo [38]

N/A

N/A

Nigeria

N/A

N/A

N/A

Yes, L

N/A

N/A

Pericardiocentesis

N/A

Died

N/A

104

Farer [39]

23

M

Vietnam

Dyspnea, chest pain

N/A

Indonesia

N/A

Microscopic finding of amebic trophozoites, anchovy sauce pus, and the response to treatment

None

Pericardiocentesis

Specific chemotherapy for amebiasis

Cure

N/A

105

Shanker [40]

30

M

India

Irregular fever and dull aching oain in right hypochondrium for 1 month

History of amoebic dysentery about 6 months back

N/A

N/A

Pericardial fluid contained trophozoites of E. histolyticaAutopsy

N/A

Pericardiocentesis

Metronidazole, ampicillin, emetine hydrochloride

Cure

N/A

106

Pirie [41]

N/A

N/A

South Africa

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

107

Baid [42]

48

M

India

Dyspnea, left chest pain, fever, edema of the feet, weakness for 1 month

N/A

N/A

Yes, R

Anchovy sauce pus and the response to treatment

Subepicardial fat-containing proliferating fibroblasts and lymphocytic infiltrate

Pericardiocentesis followed by pericardiectomy

Metronidazole

Cure

None

108

Strang [43]

N/A

N/A

South Africa

N/A

N/A

N/A

Yes

N/A

N/A

N/A

N/A

N/A

N/A

109

Blackett [44]

50

M

Cameroon

Left-sided chest pain, dyspnea, abdominal distension, edema for several days

N/A

N/A

None

The positive serological tests (1/1024) for amoebiasis, the appearance of the fluid obtained on tapping the pericardium, and the response to treatment

None

None

Metronidazole and chloroquine

Died

None

110

Vanachayangkul [45]

51

M

Thailand

Epigastric oppression and fever for 1 week beginning with severe pain, occasionally colicky in nature without nausea or vomiting

N/A

N/A

Yes

Aspiration of pericardial effusion yielded 350 mL of brownish grey pus with numerous trophozoites of active motile E. hystolytica

N/A

Pericardiocentesis followed by pericardiotomy

Metronidazole and cefotiam and amikacin

Cure

N/A

111

Lami [46]

26

F

Italy

Fever, headache, left chest pain

None

Tunisia for 2 months

None

Indirect hemagglutination test

N/A

N/A

Metronidazole 2 g daily for 10 days

Cure

N/A

112

Supe [47]

40

M

India

N/A

N/A

N/A

Yes

Elisa test for E. histolytica antibody was positive

N/A

Pericardiocentesis

Emetine, metronidazole and amikacin

Cure

N/A

113

Gomersall [48]

28

M

United Kingdom

Fever, night sweats, pyrexia, and right-sided pleuritic chest pain for 6 weeks

None

Stationed in Kenya

Yes, L

A fluorescent antibody test for E. hystolytica was positive (titer 1/320) and amoebic enzyme immunoassay was positive at 120 %

None

Pericardiocentesis

Metronidazole for 10 days and diloxanide for 10 days

Cure

No recurrence 6 months after discharge

114

Perna [49]

37

M

Italy

Fever, malaise, weight loss

Drug addiction

N/A

Yes, L

A bacteriological specimen from the pericardial fluid yielded E. hystolytica, anchovy sauce pus, and the response to treatment

N/A

Pericardiectomy

Chloroquine

N/A

N/A

115

Shandera [50]

64

M

India

Epigastric pain and pleuritic pain for 6 weeks

N/A

N/A

Yes, L

Positive serological tests for amoebiasis

None

Pericardiocentesis

Metronidazole and diiodoquinolol

Cure

N/A

116

Chao [4]

44

M

Taiwan

Dyspnea for the previous 2 days, mucoid diarrhea for 3 days

Chronic schizophrenia

N/A

Yes, L

Amebic antibodies by hemagglutination test (1:16,384)

Fibrinous exudate with polymorphic neutrophilic cell infiltration

Pericardiectomy

Metronidazole 500 mg 4 times daily for 2 weeks

Cure

No recurrence 1-year after discharge

117

Wiwanitkit [51]

N/A

N/A

Thailand

Chest pain, discomfort, and arrhythmia

N/A

N/A

Yes

N/A

N/A

N/A

N/A

Cure (n = 2) Died (n = 1)

N/A

118

Murali [52]

38

M

India

Fever and right hypochondrial pain for 10 days

N/A

N/A

Yes, R

Positive linked immunosorbent assay for E. hystolytica (both IgM and IgG)

None

Pericardiocentesis

Meropenem, metronidazole

Cure

N/A

119

Amine [53]

38

M

Morocco

Fever, shortness of breath, and leg swelling for 2 months

Recurrent diarrhea

N/A

None

Trophozoites of E. hystolytica (pleural effusion)

None

Pericardiectomy

Metronidazole 500 mg trice daily

N/A

N/A

120

Agarwal [54]

25

M

India

Abdominal pain and fever for 1 month

None

N/A

Yes, L

Anchovy sauce pus, PCR for E. hystolytica from the pericardial cavity

N/A

Pericardiocentesis, pleural pericardial window

Metronidazole

Cure

No recurrence at 1 year after discharge

121

Keleş [55]

25

M

India

Fever, chills, and pain in the upper abdomen for 1 month

N/A

N/A

Yes, L

Reddish-brown pus from the cardiac cavity, positive serological test for amebiasis, and PCR for E. hystolytica

N/A

Pericardiocentesis

Metronidazole followed by oral luminal amebicide diloxanide

Cure

No recurrence 1-year after discharge

122

Francis [56]

15

M

Turkey

Diarrhea and abdominal pain for 2 days

None

N/A

None

E. hystolytica trophozoites and cysts in fresh stool, and the response to treatment

None

None

Metronidazole (30 mg/kg/day)

Cure

No recurrence 6-month after discharge

123

Raza [57]

7

M

Pakistan

Fever and abdominal pain for 15 days and diarrhea for 3 days

Acute gastroenteritis

N/A

Yes, L

Cysts of E. histolytica and positive enzyme-linked immunosorbent assay in stool

None

None

Metronidazole for 14 days, followed by diloxanide furoate for the next 7 days

Cure

No recurrence 2-week after discharge

Current case

Matsuo^a

71

M

Japan

Epigastric pain, fatigue for 2 months

Essential thrombocytosis treated with anagrelide

Asia

None

Positive serological test for amebiasis, PCR for E. hystolytica from the pericardial cavity

N/A

Pericardiocentesis

Metronidazole 750 mg trice daily for 2 weeks, followed by paromomycin 500 mg trice daily for 10 days

Cure

No recurrence at 1 year after discharge