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Histoplasma capsulatum endocarditis

T P Blair, R A Waugh, M Pollack

    American Heart Journal
    |June 1, 1980
    PubMed
    Summary
    This summary is machine-generated.

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    Endocarditis caused by Histoplasma capsulatum is rare. This case highlights successful treatment with amphotericin B and aortic valve replacement for a patient with severe heart failure.

    Area of Science:

    • Infectious Diseases
    • Cardiology
    • Mycology

    Background:

    • Endocarditis is inflammation of the heart's inner lining, often affecting valves.
    • Disseminated Histoplasma capsulatum infection can rarely present with endocarditis.
    • Fungal endocarditis poses diagnostic and therapeutic challenges.

    Observation:

    • A 22-year-old male presented with prolonged fever, weight loss, and worsening aortic insufficiency.
    • Diagnostic clues included rising complement fixation titers for Histoplasma capsulatum and echocardiographic abnormalities.
    • Bone marrow culture confirmed disseminated Histoplasma capsulatum infection pre-operatively.

    Findings:

    • Histoplasma capsulatum was identified on the explanted aortic valve during replacement surgery.

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  • The patient received a combination of amphotericin B and surgical intervention.
  • Successful treatment led to resolution of symptoms and cure.

    • Implications:

    • This case underscores the importance of considering fungal infections in endocarditis, especially in endemic areas.
    • Aggressive management combining antifungal therapy and valve replacement can be curative for Histoplasma endocarditis.
    • Early diagnosis and multidisciplinary care are crucial for managing rare manifestations of Histoplasma capsulatum.