Culture-Confirmed Histoplasma Endocarditis on Bioprosthetic Mitral Valve Managed Successfully Without Surgery.

ABSTRACT:

Background

Prosthetic valve endocarditis due to Histoplasma capsulatum is exceedingly rare and difficult to diagnose.

Case summary

A 79-year-old man with a bioprosthetic mitral valve presented with subacute cognitive decline, pancytopenia, and hypercalcemia. He was afebrile and hemodynamically stable. Echocardiography showed vegetations on the valve. Initially, blood cultures were negative. Urine Histoplasma antigen and serum beta-D-glucan were positive, and fungal blood cultures later grew H capsulatum after 4 weeks of incubation. He was managed with liposomal amphotericin B followed by isavuconazole due to itraconazole contraindications. He gradually recovered without surgical intervention.

Discussion

This case illustrates the diagnostic and treatment complexities o

SUBMITTER: Hlupeni A 

PROVIDER: S-EPMC12540298 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature