Histoplasma endocarditis on a stenosed aortic valve presenting as dysphagia and weight loss

A 40-year-old man with aortic stenosis and disseminated histoplasmosis did not respond to treatment with itraconazole. Though there was no haemodynamic deterioration, valvar regurgitation, or embolic phenomena a presumptive diagnosis of infective endocarditis was made. This was confirmed at aortic v...

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Bibliographic Details
Published in:British Heart Journal 1993-12, Vol.70 (6), p.565-567
Main Authors: Wilmshurst, P T, Venn, G E, Eykyn, S J
Format: Article
Language:English
Subjects:
Adult
Amphotericin B - therapeutic use
Aortic Valve
Aortic Valve Stenosis - complications
Aortic Valve Stenosis - surgery
Biological and medical sciences
Combined Modality Therapy
Deglutition Disorders - etiology
Endocarditis - complications
Endocarditis - drug therapy
Endocarditis - surgery
Follow-Up Studies
Heart Valve Prosthesis
Histoplasmoses
Histoplasmosis - complications
Histoplasmosis - drug therapy
Histoplasmosis - surgery
Human mycoses
Humans
Infectious diseases
Itraconazole - therapeutic use
Male
Medical sciences
Mycoses
Tropical mycoses
Weight Loss
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Summary:A 40-year-old man with aortic stenosis and disseminated histoplasmosis did not respond to treatment with itraconazole. Though there was no haemodynamic deterioration, valvar regurgitation, or embolic phenomena a presumptive diagnosis of infective endocarditis was made. This was confirmed at aortic valve replacement. Antifungal treatment was continued for 18 months after valve replacement and serological tests for Histoplasma became progressively more negative during a three year follow up.
ISSN:0007-0769
1355-6037
1468-201X
2053-5864
DOI:10.1136/hrt.70.6.565