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Histoplasma capsulatum culture-negative prosthetic valve endocarditis presenting as a cystic mass
  1. Jung-In Choi1,
  2. Alice S Chang2,
  3. Richard C Cook3 and
  4. Christopher B Fordyce2
  1. 1Internal Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
  2. 2Cardiology, The University of British Columbia, Vancouver, British Columbia, Canada
  3. 3Cardiovascular Surgery, The University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Jung-In Choi; jungin.choi{at}


A 58-year-old immunocompetent patient with previous prosthetic valve presented with chest pain, constitutional symptoms and septic shock. Blood cultures and transthoracic echocardiogram were negative, but the patient was initiated on broad spectrum antibiotics due to high clinical suspicions of infective endocarditis. The patient received a transoesophageal echocardiogram revealing a cystic bioprosthetic valve lesion. Culture-negative endocarditis workup identified active disseminated histoplasmosis with likely Histoplasma endocarditis. A multidisciplinary discussion was held, and the patient was deemed high-risk for a third re-do open heart surgery. He was treated medically with anti-fungal treatment with good clinical recovery.

  • valvar diseases
  • infectious diseases

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  • Contributors J-IC, ASC, RCC and CBF were involved in the clinical management of the patient. J-IC and ASC contributed to the conceptualisation and planning of the manuscript. All authors were involved in the writing/reporting, reviewing and approval of the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.