{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:30:14Z","timestamp":1787682614988,"version":"build-2784847793"},"reference-count":56,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:p>\n                    <jats:italic>Context<\/jats:italic>\n                    .\u2014Endovascular infection is an uncommon but devastating manifestation of histoplasmosis, which is often diagnosed late in disease.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Objectives<\/jats:italic>\n                    .\u2014To evaluate the clinical and pathologic characteristics of patients with endovascular infections caused by\n                    <jats:italic>Histoplasma capsulatum.<\/jats:italic>\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Design<\/jats:italic>\n                    .\u2014All cases of patients with documented endovascular histoplasmosis at a single tertiary care center in an endemic region during the period 1993\u20132010 were reviewed.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results<\/jats:italic>\n                    .\u2014Patients presented with a subacute febrile illness and a history of endovascular devices. All patients had positive\n                    <jats:italic>Histoplasma<\/jats:italic>\n                    serology. Routine bacterial culture results were negative for all patients. In addition to yeast forms typical of histoplasmosis, pathologic findings also revealed mycelial forms in 4 of 5 patients. Inflammation was scant. Urinary antigen detection was positive in 4 of 5 patients and\n                    <jats:italic>Histoplasma<\/jats:italic>\n                    blood culture results were positive for 3 of 5 patients. Four patients were treated with a combination of surgical and medical therapy, which consisted of amphotericin B followed by itraconazole; these 4 patients had complete resolution of symptoms and no documented relapse. One patient died before planned surgery.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    .\u2014\n                    <jats:italic>Histoplasma capsulatum<\/jats:italic>\n                    endovascular infections are clinically characterized by a subacute febrile illness with negative bacterial cultures in patients with prosthetic endografts or valves. Noninvasive diagnostics are often the initial clue to the diagnosis. Combined medical and surgical treatment is associated with survival. On histopathologic examination both mycelial and yeast forms are often observed, with absent to minimal tissue inflammatory reaction.\n                  <\/jats:p>","DOI":"10.5858\/arpa.2011-0050-oa","type":"journal-article","created":{"date-parts":[[2012,5,30]],"date-time":"2012-05-30T12:57:32Z","timestamp":1338382652000},"page":"640-645","source":"Crossref","is-referenced-by-count":21,"title":["Endovascular Infections Caused by Histoplasma capsulatum: A Case Series and Review of the Literature"],"prefix":"10.5858","volume":"136","author":[{"given":"Christopher","family":"Ledtke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan J.","family":"Rehm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas G.","family":"Fraser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabin K.","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmela D.","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E Rene","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Walton","family":"Tomford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Jain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Lytle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Johnston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Sabik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Gordon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"van Duin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"issue":"3","key":"i1543-2165-136-6-640-b01","series-title":"Public Health Rep","first-page":"241","article-title":"Nationwide histoplasmin sensitivity and histoplasmal infection","volume":"78","author":"Edwards\n              PQ,","year":"1963","unstructured":"Edwards\n              PQ, \n            \n              Palmer\n              CE\n            \n          . Nationwide histoplasmin sensitivity and histoplasmal infection. Public Health Rep. 1963;78(3):241\u2013260."},{"issue":"10","key":"i1543-2165-136-6-640-b02","series-title":"Pediatr Infect Dis J","first-page":"909","article-title":"A large histoplasmosis outbreak among high school students in Indiana, 2001","volume":"23","author":"Chamany\n              S,","year":"2004","unstructured":"Chamany\n              S, \n            \n              Mirza\n              SA, \n            \n              Fleming\n              JW\n            , et al. \n          A large histoplasmosis outbreak among high school students in Indiana, 2001. 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Am J Med. 1973;54(3):333\u2013342."},{"issue":"1","key":"i1543-2165-136-6-640-b05","series-title":"Clin Microbiol Rev","first-page":"115","article-title":"Histoplasmosis: a clinical and laboratory update","volume":"20","author":"Kauffman\n              CA","year":"2007","unstructured":"Kauffman\n              CA\n            \n          . Histoplasmosis: a clinical and laboratory update. Clin Microbiol Rev. 2007;20(1):115\u2013132."},{"issue":"2","key":"i1543-2165-136-6-640-b06","series-title":"South Med J","first-page":"208","article-title":"Fatal reactive hemophagocytosis related to disseminated histoplasmosis with endocarditis: an unusual case diagnosed at autopsy","volume":"100","author":"Wang\n              Z,","year":"2007","unstructured":"Wang\n              Z, \n            \n              Duarte\n              AG, \n            \n              Schnadig\n              VJ\n            \n          . Fatal reactive hemophagocytosis related to disseminated histoplasmosis with endocarditis: an unusual case diagnosed at autopsy. South Med J. 2007;100(2):208\u2013211."},{"issue":"6","key":"i1543-2165-136-6-640-b07","series-title":"Br Heart J","first-page":"565","article-title":"Histoplasma endocarditis on a stenosed aortic valve presenting as dysphagia and weight loss","volume":"70","author":"Wilmshurst\n              PT,","year":"1993","unstructured":"Wilmshurst\n              PT, \n            \n              Venn\n              GE, \n            \n              Eykyn\n              SJ\n            \n          . Histoplasma endocarditis on a stenosed aortic valve presenting as dysphagia and weight loss. Br Heart J. 1993;70(6):565\u2013567."},{"issue":"1","key":"i1543-2165-136-6-640-b08","series-title":"Rev Inst Med Trop Sao Paulo","first-page":"19","article-title":"Acute disseminated histoplasmosis and endocarditis","volume":"40","author":"Scapellato\n              PG,","year":"1998","unstructured":"Scapellato\n              PG, \n            \n              Desse\n              J, \n            \n              Negroni\n              R\n            \n          . Acute disseminated histoplasmosis and endocarditis. 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Can J Cardiol. 2001;17(3):297\u2013303."},{"issue":"1","key":"i1543-2165-136-6-640-b13","series-title":"Ann Surg","first-page":"57","article-title":"Histoplasma infection of abdominal aortic aneurysms","volume":"197","author":"Miller\n              BM,","year":"1983","unstructured":"Miller\n              BM, \n            \n              Waterhouse\n              G, \n            \n              Alford\n              RH, \n            \n              Dean\n              RH, \n            \n              Hawkins\n              SS, \n            \n              Smith\n              BM\n            \n          . Histoplasma infection of abdominal aortic aneurysms. Ann Surg. 1983;197(1):57\u201362."},{"issue":"4","key":"i1543-2165-136-6-640-b14","series-title":"J Vasc Surg","first-page":"649","article-title":"Successful management of Histoplasma capsulatum infection of an abdominal aortic aneurysm","volume":"3","author":"Harris\n              RL,","year":"1986","unstructured":"Harris\n              RL, \n            \n              Lawrie\n              GM, \n            \n              Wheeler\n              TM\n            , et al. \n          Successful management of Histoplasma capsulatum infection of an abdominal aortic aneurysm. 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Arch Pathol Lab Med. 1985;109(4):330\u2013332."},{"issue":"2","key":"i1543-2165-136-6-640-b18","series-title":"Medicine (Baltimore)","first-page":"94","article-title":"Fungal prosthetic valve endocarditis in 16 patients: an 11-year experience in a tertiary care hospital","volume":"76","author":"Melgar\n              GR,","year":"1997","unstructured":"Melgar\n              GR, \n            \n              Nasser\n              RM, \n            \n              Gordon\n              SM, \n            \n              Lytle\n              BW, \n            \n              Keys\n              TF, \n            \n              Longworth\n              DL\n            \n          . Fungal prosthetic valve endocarditis in 16 patients: an 11-year experience in a tertiary care hospital. Medicine (Baltimore). 1997;76(2):94\u2013103."},{"issue":"1","key":"i1543-2165-136-6-640-b19","series-title":"J Infect","first-page":"2","article-title":"Histoplasma endocarditis: clinical and mycologic features and outcomes","volume":"51","author":"Bhatti\n              S,","year":"2005","unstructured":"Bhatti\n              S, \n            \n              Vilenski\n              L, \n            \n              Tight\n              R, \n            \n              Smego\n              RA\n              Jr\n            \n          . Histoplasma endocarditis: clinical and mycologic features and outcomes. 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Fatal reactive hemophagocytosis related to disseminated histoplasmosis with endocarditis: an unusual case diagnosed at autopsy. South Med J. 2007;100(2):208\u2013211."},{"issue":"6","key":"i1543-2165-136-6-640-b07","series-title":"Br Heart J","first-page":"565","article-title":"Histoplasma endocarditis on a stenosed aortic valve presenting as dysphagia and weight loss","volume":"70","author":"Wilmshurst\n              PT,","year":"1993","unstructured":"Wilmshurst\n              PT, \n            \n              Venn\n              GE, \n            \n              Eykyn\n              SJ\n            \n          . Histoplasma endocarditis on a stenosed aortic valve presenting as dysphagia and weight loss. 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Can J Cardiol. 2001;17(3):297\u2013303."},{"issue":"1","key":"i1543-2165-136-6-640-b13","series-title":"Ann Surg","first-page":"57","article-title":"Histoplasma infection of abdominal aortic aneurysms","volume":"197","author":"Miller\n              BM,","year":"1983","unstructured":"Miller\n              BM, \n            \n              Waterhouse\n              G, \n            \n              Alford\n              RH, \n            \n              Dean\n              RH, \n            \n              Hawkins\n              SS, \n            \n              Smith\n              BM\n            \n          . Histoplasma infection of abdominal aortic aneurysms. Ann Surg. 1983;197(1):57\u201362."},{"issue":"4","key":"i1543-2165-136-6-640-b14","series-title":"J Vasc Surg","first-page":"649","article-title":"Successful management of Histoplasma capsulatum infection of an abdominal aortic aneurysm","volume":"3","author":"Harris\n              RL,","year":"1986","unstructured":"Harris\n              RL, \n            \n              Lawrie\n              GM, \n            \n              Wheeler\n              TM\n            , et al. \n          Successful management of Histoplasma capsulatum infection of an abdominal aortic aneurysm. 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