Histoplasma capsulatum endocarditis requiring aortic valve replacement for aortic insufficiency

A patient with valvular heart disease was found to have disseminated histoplasmosis and Histoplasma endocarditis. Refractory congestive heart failure secondary to severe progressive aortic insufficiency and the presence of a large valvular vegetation necessitated aortic valve replacement, which was timed to coincide with the midpoint of a course of therapy with 4 gm of amphotericin B. The patient has done well since the completion of treatment.