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 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.
Wilmshurst
P T
PT
Department of Cardiology, St Thomas' Hospital, London.
Venn
G E
GE
Eykyn
S J
SJ
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000601:surgery; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology*; D004696:Endocarditis / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006660:Histoplasmosis / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D015431:Weight Loss
D017964:Itraconazole; D000666:Amphotericin B