Uncommon aortic prosthesis vegetation due to Histoplasma capsulatum: clinical and laboratory aspects.

We describe a rare case of Histoplasma capsulatum prosthetic aortic valve endocarditis in an immunocompetent patient with previous histoplasmosis. Diagnosis was established by direct microscopy, culture, and molecular identification from excised valve tissue. Antifungal susceptibility testing showed low MICs to amphotericin B and azoles, with limited echinocandin activity. Thus, after surgical valve replacement and liposomal amphotericin B therapy, the patient was discharged with a good outcome.