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Histoplasma Endocarditis Diagnosed by Thrombus Aspiration
Hussain Alzayer1, José Winter1, Ahmad Alshatti1
1Division of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
The Canadian Journal of Cardiology
|October 2, 2018
Summary
Culture-negative endocarditis can delay treatment. Diagnosis of fungal endocarditis was made after coronary embolization and myocardial infarction, highlighting a serious cause of negative cultures.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Diagnostics
Background:
- Endocarditis diagnosis is often culture-dependent.
- Negative blood cultures in endocarditis can impede timely, targeted therapy.
- Fungal endocarditis presents a diagnostic challenge, often with negative cultures.
Observation:
- A 68-year-old male presented with symptoms suggestive of endocarditis.
- The patient experienced coronary embolization leading to anterior ST-elevation myocardial infarction (STEMI).
- Initial cultures were negative, characteristic of culture-negative endocarditis.
Findings:
- Aspiration thrombectomy was performed for the myocardial infarction.
- Histopathological analysis of the embolic material revealed fungal elements.
- This led to the definitive diagnosis of fungal endocarditis.
Implications:
- Fungal endocarditis is a critical, potentially fatal cause of culture-negative endocarditis.
- Early diagnosis and treatment are crucial for improving patient outcomes.
- This case underscores the importance of considering non-bacterial causes in culture-negative endocarditis, especially with embolic complications.
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