CARDIAC PENTASTOMIASIS AND TUBERCULOSIS - THE WORM-EATEN HEART

We report an autopsy case of disseminated tuberculosis and a coexistin g, extremely rare parasitic zoonosis: pentastomiasis. The parasite was incidentally found in the pericardial sac and epicardium, associated with tuberculous pericarditis, in a 43-year-old woman from Georgia wit h presumptive Acquired Immunodeficiency Syndrome (AIDS). The cuticle w as the only remaining intact structure of the parasite. The internal o rgans had undergone autolysis, but recognizable features were apparent . Gross and microscopic findings were highly suggestive of pentastomid species. The ultrastructure of the cuticle was consistent with a pent astomid arthropod. This is one of the few cases of visceral pentastomi asis reported in North America, and the first known example of heart i nvolvement. The association of the parasitic infection and tuberculous pericarditis makes the case even more unusual.