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

<i>Histoplasma</i> 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 <i>Histoplasma</i> endocarditis of his native mitral valve. Our patient's nonspecific symptoms posed a diagnostic challenge, which resulted in delayed diagnosis and treatment.