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

Abstract

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. Antgal treatment was continued for 18 months after valve replacement and serological tests for Histoplasma became progressively more negative during a three year follow up.