Acute opioid detoxification revealing a unique challenge in clinical management

Abstract

Introduction: Opioid abuse in pregnancy is inherit to a multitude of adverse outcomes for both mother and fetus, with use of intra-dermal injections for drug delivery leading to systemic sequela such as endocarditis. In patients with history of drug abuse, infective endocarditis most frequently presents as a subacute disease process that requires high clinical suspicion. Case Report: We report a case of a 21-year-old caucasian female, G3P0020, who presented to the emergency department in a state of acute opioid withdraw. Initial investigation detailed a positive pregnancy test and leukocytosis. The extensive workup revealing a viable embryo and culture negative endocarditis (CNE) with vegetation on tricuspid valve and further care ensuring proper treatment for inpatient course. Conclusion: We present a clinical case of intravenous-opioid derived CNE composed of challenges that required multiple disciplines and collaboration of multiple specialties in the gravid patient along with detailed information on management in this subset of patients.