First report of infectious endocarditis due to Histoplasma capsulatum in Mexico

Authors

  • Luis Javier Méndez-Tovar <p>Instituto Mexicano del Seguro Social, Hospital de Especialidades &ldquo;Dr. Bernardo Sep&uacute;lveda&rdquo;, Unidad de Investigaci&oacute;n M&eacute;dica en Epidemiolog&iacute;a Cl&iacute;nica. Ciudad de M&eacute;xico</p>
  • Priscila M. Rangel-Delgado <p>Instituto Mexicano del Seguro Social. Hospital de Cardiolog&iacute;a, CMN Siglo XXI, Departamento de Patolog&iacute;a Cl&iacute;nica,&nbsp; IMSS. Ciudad de M&eacute;xico</p>
  • Francisca Hernández-Hernández <p>Universidad Nacional Aut&oacute;noma de M&eacute;xico, Facultad de Medicina, Unidad de Micolog&iacute;a, Departamento de Microbiolog&iacute;a y Parasitolog&iacute;a. Ciudad de M&eacute;xico</p>
  • Antonio Flores-García <p>Instituto Mexicano del Seguro Social, Hospital de Cardiolog&iacute;a, Servicio de Anatom&iacute;a Patol&oacute;gica. Ciudad de M&eacute;xico</p>
  • Gladys Galicia-Castelán <p>Instituto Mexicano del Seguro Social, Hospital de Cardiolog&iacute;a, Departamento de Patolog&iacute;a Cl&iacute;nica. Ciudad de M&eacute;xico</p>
  • Patricia Manzano-Gayosso <p>Universidad Nacional Aut&oacute;noma de M&eacute;xico, Facultad de Medicina, Unidad de Micolog&iacute;a, Departamento de Microbiolog&iacute;a y Parasitolog&iacute;a. Ciudad de M&eacute;xico</p>
  • Erika Córdova-Martínez <p>Universidad Nacional Aut&oacute;noma de M&eacute;xico, Facultad de Medicina, Unidad de Micolog&iacute;a, Departamento de Microbiolog&iacute;a y Parasitolog&iacute;a. Ciudad de M&eacute;xico</p>

Keywords:

Endocarditis, Histoplasma capsulatum, Diagnosis, Mexico

Abstract

Background: Infectious endocarditis of fungal origin is rare but of high mortality. The agents involved are mainly opportunists of the genus Candida and Aspergillus; however other fungi can also cause this disease.

Clinical case: The case of a woman who suffered unknown origin intermittent fever for several months; and in who, by blood culture (after lysis-centrifugation) and molecular biology techniques, Histoplasma capsulatum was identified as etiological agent. The histological study showed abundant intracellular yeasts and hyphae in intracardiac vegetations.

Conclusion: This first report of infectious endocarditis by H. capsulatum in Mexico highlights the importance of using in addition to manual blood culture (lysis-centrifugation) and histological study, faster and more sensitive diagnostic methods, such as serology and molecular biology, to confirm or rule out an invasive fungal infection and identify the agents.

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Published

2020-01-30

Issue

Vol. 57 No. 3 (2019): May-June

Section

Clinical Cases

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