# Histoplasma Endocarditis of the Native Mitral Valve in a Patient With End-Stage Renal Disease: A Diagnostic Challenge

## TL;DR

A patient with kidney disease faced a difficult diagnosis of rare Histoplasma endocarditis due to vague symptoms and negative blood tests.

## Contribution

This case highlights the diagnostic challenges of Histoplasma endocarditis in immunocompromised patients with nonspecific symptoms.

## Key findings

- Histoplasma endocarditis was diagnosed in a patient with end-stage renal disease after multiple hospitalizations.
- The patient's symptoms were nonspecific, leading to a delayed diagnosis despite negative blood cultures.
- The infection affected the native mitral valve, a rare presentation of Histoplasma endocarditis.

## Abstract

Histoplasma is a rare cause of endocarditis. It usually occurs in immunosuppressed patients, but diagnosis can be challenging given its nonspecific clinical and laboratory findings. This report describes the case of a patient with end-stage renal disease and multiple hospitalizations who was diagnosed with blood culture-negative infective endocarditis and subsequently found to have Histoplasma endocarditis of his native mitral valve. Our patient’s nonspecific symptoms posed a diagnostic challenge, which resulted in delayed diagnosis and treatment.