ArticleMedicine2014
Histoplasma capsulatum endocarditis: multicenter case series with review of current diagnostic techniques and treatment.
Article in Medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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Who cites it
32 citing papers in PubMed.
- Article
- Diagnostic, cardiac imaging, and management considerations in fungal infective endocarditis: a contemporary narrative review.Cardiovascular diagnosis and therapy · 2026Review
- Disseminated Histoplasmosis and Aortic Valve Infective Endocarditis in a Patient With Recent Aortobifemoral Bypass.The American journal of case reports · 2026Article
- Rapid gain and loss of a chromosome drives key morphology and virulence phenotypes in the fungal pathogen Histoplasma.PLoS biology · 2026Article
- Diagnostic challenges in culture-negative infective endocarditis: a case of histoplasma endocarditis: a case report.Journal of medical case reports · 2025Article
- Contemporary Cleveland Clinic experience of fungal infective endocarditis: a focus on imaging and outcomes.European heart journal. Imaging methods and practice · 2025Article
- Culture-Confirmed Histoplasma Endocarditis on Bioprosthetic Mitral Valve Managed Successfully Without Surgery.JACC. Case reports · 2025Article
- Characteristics and Outcomes of Hospitalized Patients with Histoplasmosis: Comparison of Immunocompromised and Non-Immunocompromised Adult Patients.Journal of fungi (Basel, Switzerland) · 2025Article
- Histoplasma capsulatum Prosthetic Valve Endocarditis Diagnosed via Cell-Free DNA Sequencing.Cureus · 2025Article
- Article
- Chronic Cavitary Pulmonary Histoplasmosis-Novel Concepts Regarding Pathogenesis.Journal of fungi (Basel, Switzerland) · 2025Article
- Infectious factors in myocarditis: a comprehensive review of common and rare pathogens.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2024Review
- Pulmonary Histoplasmosis Complicated by Nonvalvular Right Ventricular WallInternational journal of surgical pathology · 2024Article
- Article
- Article
- Fungal Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management.Clinical microbiology reviews · 2023Review
- Article
- Rare case ofEuropean heart journal. Case reports · 2022Article
- Article
- Native vs Prosthetic ValveOpen forum infectious diseases · 2021Review
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Infective endocarditis is an uncommon manifestation of infection with Histoplasma capsulatum. The diagnosis is frequently missed, and outcomes historically have been poor. We present 14 cases of Histoplasma endocarditis seen in the last decade at medical centers throughout the United States. All patients were men, and 10 of the 14 had an infected prosthetic aortic valve. One patient had an infected left atrial myxoma. Symptoms were present a median of 7 weeks before the diagnosis was established. Blood cultures yielded H. capsulatum in only 6 (43%) patients. Histoplasma antigen was present in urine and/or serum in all but 3 of the patients and provided the first clue to the diagnosis of histoplasmosis for several patients. Antibody testing was positive for H. capsulatum in 6 of 8 patients in whom the test was performed. Eleven patients underwent surgery for valve replacement or myxoma removal. Large, friable vegetations were noted at surgery in most patients, confirming the preoperative transesophageal echocardiography findings. Histopathologic examination of valve tissue and the myxoma revealed granulomatous inflammation and large numbers of organisms in most specimens. Four of the excised valves and the atrial myxoma showed a mixture of both yeast and hyphal forms on histopathology. A lipid formulation of amphotericin B, administered for a median of 29 days, was the initial therapy in 11 of the 14 patients. This was followed by oral itraconazole therapy, in all but 2 patients. The length of itraconazole suppressive therapy ranged from 11 months to lifelong administration. Three patients (21%) died within 3 months of the date of diagnosis. All 3 deaths were in patients who had received either no or minimal (1 day and 1 week) amphotericin B.
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