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July 1962

Histoplasma Capsulatum Endocarditis with Major Arterial Embolism: Report of an Apparent Recovery

Author Affiliations


George Hunter Laboratory, Department of Medicine, Vanderbilt University.; U.S. Public Health Service Postdoctoral Fellows, National Institute of Allergy and Infectious Diseases (Drs. Derby and Coolidge).

Arch Intern Med. 1962;110(1):63-69. doi:10.1001/archinte.1962.03620190065010

Although numerous cases of progressive disseminated histoplasmosis have been reported during the last 15 years, endocardial involvement has been rare. A review of reported instances of fungal endocarditis published in 1958 included 12 due to Histoplasma capsulatum,1 and only one subsequent case has been documented.2 To our knowledge, no patient with disseminated Histoplasma infection and established endocarditis has previously survived.

The present paper reports observations on a patient with progressive, disseminated histoplasmosis and clinical evidence of endocardial involvement who apparently is free of infection 20 months after cessation of therapy with amphotericin B and sulfonamides.

Report of Case  A 27-year-old housewife from Western Kentucky was admitted to the medical service on Aug. 24, 1959, because of 10 months of intermittent fever, weight loss, and recent sudden paresis of the right leg. In October of 1958, she had first noted the onset of fever occurring irregularly once or twice

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