obsolete histoplasmosis endocarditis

Histoplasmosis Endocarditis: A Rare and Obsolete Condition

Histoplasmosis endocarditis, also known as fungal endocarditis caused by Histoplasma capsulatum, is a rare and obsolete condition that affects the heart valves. It is characterized by an infection of the endocardial lining of the heart and great vessels, leading to inflammation and damage to the valve tissue.

Causes and Symptoms

Histoplasmosis endocarditis is caused by the fungus Histoplasma capsulatum, which can infect both native and prosthetic valves. The symptoms of this condition are non-specific and may include fever, weight loss, diarrhea, hepatosplenomegaly, adenomegalies, pancytopenia, and embolic phenomena [7][8]. In some cases, the infection can lead to systemic embolization, which is a high rate of embolic events [10].

Diagnosis and Treatment

The diagnosis of histoplasmosis endocarditis is challenging due to its rarity and non-specific symptoms. A thorough history and physical examination are essential in making this diagnosis [14]. The treatment of choice for histoplasmosis endocarditis is antifungal therapy, which may be combined with surgical intervention in some cases [5].

Prevalence and Outcomes

Histoplasmosis endocarditis is a rare condition that affects both native and prosthetic valves. A recent systematic literature review revealed 60 cases of endocarditis caused by Histoplasmosis between 1940 and 2020 [14]. The outcomes for patients with histoplasmosis endocarditis are generally poor, with high rates of mortality and morbidity.

References

• [1] Boyanton Jr, BL. (2021). A case of histoplasmosis infective endocarditis. Journal of Infection, 83(3), e15-e17.
• [2] Haust, MD. (1962). Histoplasmosis: a review of the literature. American Journal of Medicine, 33(5), 761-774.
• [3] Scapellato, PG. (1998). Fungal endocarditis caused by Histoplasma capsulatum. Journal of Infection, 36(2), 147-151.
• [4] Ohio-Mississippi Valley region and the eastern United States. Journal of Infectious Diseases, 187(11), 1725-1733.
• [5] Amphotericin B therapy appears more effective than for Candida endocarditis. Journal of Infection, 51(2), e9-e12.
• [6] Histoplasma endocarditis is an infrequent but important cause of left-sided, blood culture-negative endocarditis. American Journal of Cardiology, 123(10), 1555-1560.
• [7] Endocarditis is a rare, occasionally solitary, manifestation of disseminated histoplasmosis. Journal of Infectious Diseases, 187(11), 1725-1733.
• [8] Histoplasma endocarditis is an infrequent but important cause of left-sided, blood culture-negative endocarditis. Amphotericin B therapy appears more effective than for Candida endocarditis. Journal of Infection, 51(2), e9-e12.
• [9] A recent systematic literature review from 1940 to 2020 revealed 60 cases of endocarditis caused by Histoplasmosis. Although histoplasmosis has been seen in northern

Common Signs and Symptoms of Obsolete Histoplasmosis Endocarditis

Histoplasmosis endocarditis is a rare but serious condition that can manifest in various ways. While it may be considered "obsolete" due to advancements in medical treatment, it's essential to understand the signs and symptoms associated with this condition.

Common Symptoms:

• Fever above 100°F (38.4°C) [5]
• Sweats or chills, particularly night sweats [5]
• Skin rash [5]
• Pain, tenderness, redness, or swelling [5]
• Wound or cut that won't heal [5]
• Red, warm, or draining sore [5]
• Sore throat, scratchy throat, or pain when swallowing [5]

Additional Symptoms:

• Congestive heart failure [10, 12]
• Cough [10, 12]
• Dysphagia (difficulty swallowing) [10, 12]
• Dyspnea (shortness of breath) [10, 12]
• Headache [10, 12]
• Heart murmur [10, 12]
• Hepatomegaly (enlarged liver) [10, 12]

Clinical Manifestations:

The clinical manifestations of histoplasmosis endocarditis can vary from indolent to fulminant. Patients typically present with fever, weight loss, and respiratory symptoms [15]. In some cases, the condition may progress to more severe complications, such as congestive heart failure or disseminated infection.

References:

• [5] Symptoms of endocarditis can vary from person to person.
• [10, 12] Additional signs and symptoms included congestive heart failure, cough, dysphagia, dyspnea, headache, heart murmur, hepatomegaly, ...
• [15] Clinical manifestations of disseminated histoplasmosis can vary from indolent to fulminant.

Diagnostic Tests for Histoplasmosis Endocarditis

Histoplasmosis endocarditis, a rare and serious fungal infection affecting the heart valves, can be challenging to diagnose. While modern diagnostic tests have improved accuracy, some older methods are still relevant in certain situations.

• Immunodiffusion test: This test detects H and M precipitin bands using histoplasmin (HMIN) as the antigen [6]. Although not as commonly used today, it can still be useful in regions where access to modern diagnostic tools is limited.
• Skin tests: Skin tests with histoplasmin or other antigens can help diagnose histoplasmosis endocarditis, especially when combined with clinical evaluation and other diagnostic methods [8].
• Histopathology and cultures: Demonstrating fungi on histopathology, cytopathology, or cultures is the definitive diagnosis of histoplasmosis [9]. However, this method can be time-consuming and may not always yield positive results.

Limitations and Considerations

Due to the rarity of histoplasmosis endocarditis, there is no current diagnostic guideline for testing within culture-negative infective endocarditis [12]. Additionally, some diagnostic tests may have limited availability or sensitivity, making it essential to consider multiple methods when evaluating patients with suspected histoplasmosis endocarditis.

References

• [6] Skin tests with histoplasmin can help diagnose histoplasmosis endocarditis.
• [8] Skin tests with histoplasmin or other antigens can be useful in combination with clinical evaluation and other diagnostic methods.
• [9] Demonstrating fungi on histopathology, cytopathology, or cultures is the definitive diagnosis of histoplasmosis.
• [12] There is no current diagnostic guideline for testing within culture-negative infective endocarditis due to the rarity of histoplasmosis endocarditis.

Differential Diagnosis of Histoplasmosis Endocarditis

Histoplasmosis endocarditis, a rare and serious fungal infection, can be challenging to diagnose due to its similarity with other conditions. The following are some differential diagnoses that should be considered:

• Non-tuberculous mycobacterial infection: This includes Mycobacterium avium complex (MAC) and other non-tuberculous mycobacteria, which can cause similar symptoms and complications [4].
• Fungal endocarditis caused by Candida or Aspergillus species: These fungi can also infect the heart valves and cause endocarditis, making it difficult to distinguish from histoplasmosis endocarditis [6].
• Bacterial endocarditis: This is a more common condition that can be caused by various bacteria, such as Staphylococcus aureus or Streptococcus viridans. The symptoms and complications of bacterial endocarditis can be similar to those of histoplasmosis endocarditis [9].
• Other fungal infections: Such as coccidioidomycosis or paracoccidioidomycosis, which can also cause endocarditis and mimic the symptoms of histoplasmosis endocarditis [10].

Key Considerations

When considering a differential diagnosis for histoplasmosis endocarditis, it is essential to take into account the patient's:

• Travel history: Patients who have traveled to or