Acute disseminated histoplasmosis and endocarditis

Abstract

Acute disseminated histoplasmosis is a frequent condition in HIV carriers. Thirty-five cases of endocarditis caused by Histoplasma capsulatum have been reported in international literature, and all these descriptions correspond to a context of subacute disseminated histoplasmosis. This paper presents the case of a HIV-positive patient with fever, dyspnea, weight loss, vomiting and polyadenopathies to whom histoplasmosis was diagnosed following blood-cultures and isolation of the agent responsible for cutaneous lesions, and in whom aortic-valve vegetations were found during an echocardiogram. The patient was treated with amphotericin B and had a good outcome; subsequent echocardiograms showed no vegetations. Literature on the subject is reviewed, with special emphasis on diagnosis and treatment of previously described cases.

Native vs Prosthetic Valve Histoplasma capsulatum Infective Endocarditis: A Case Report and Systemic Literature Review Comparing Patient Presentation, Treatment Modalities, Clinical Outcomes, and Diagnostic Laboratory Testing

“…Of these, only 6 were tested for HIV. One of these 6 was HIV-positive (case 37) [ 35 ], yielding an estimated HIV positivity rate of 16.7%.…”

“…To our knowledge, individuals in this review did not have prosthetic tricuspid or pulmonic valves or risk factors (ie, intravenous drug use) predisposing them to have undergone native tricuspid or pulmonic valve replacement. There was only 1 intravenous drug user in this review, but he had native valve infection [ 35 ]. In this review, there were only 33 cases from 1980 or later whereby HIV infection could have been possible.…”

“…In this review, there were only 33 cases from 1980 or later whereby HIV infection could have been possible. Of these, only 6 individuals had HIV testing performed; the 1 positive individual was the aforementioned intravenous drug user [ 35 ].…”

Cardiovascular Pathology in AIDS

“…Aspergillus is difficult to isolate with blood cultures. Microscopically, the vegetations are composed in large part of long branching septate hyphae [61,63,64].…”