HISTOPLASMA capsulatum is a rare cause of infective endocarditis. Three patients have previously been described with postoperative histoplasma endocarditis.1-3 We describe here a patient with prosthetic valve endocarditis (PVE) and chronic meningitis caused by H capsulatum. This organism should be considered in the evaluation of patients with intracardiac prostheses, fever, and negative blood cultures.
Report of a Case
In January 1972, a 37-year-old man had a stenotic aortic valve replaced by a homograft. In September 1975, he noted dyspnea on exertion, and aortic regurgitation was detected. Diuretics and digitalis were prescribed, but heart failure worsened. On March 23, 1976, the defective homograft was replaced at our hospital by a Bjork-Shiley aortic prosthesis. The excised hemograft showed only fibrosis and calcification. The patient did well until July 1976, when fever and weight loss were noted, followed by right hemiparesis and aphasia. He was admitted to another hospital, where CSF was