Abstract
Objective: To describe the clinical, laboratory, microbiological, and echocardiographic findings in four intravenous drug users with endocarditis hospitalized and followed in our Infectious Disease Service, a tertiary university hospital as well as to determine the efficacy of medical treatment. Methods: From a database of 35 subjects with endocarditis during five years, we made a retrospective analysis of data for four cases between the age of 24-33 years old which were intravenous drug users. Results: Infective endocarditis was encountered in four drug users with positive blood cultures (Staphylococcus aureus was present in all the cases), vegetations in the tricuspid native valve in ultrasound, high fever (more than 38oC). The four cases were male and the mean age was 29 years (range 24-33 years). Three out of the four cases presented with pulmonary involvement and only one with femoral and popliteal vein thrombosis. Two out of four cases had acute renal and hepatic failure and only one had acute cutaneous vasculitis. Transesophageal Echocardiography (TEE) was also performed in two cases. For all of them medical management consisted of antibiotic therapy and two out of them underwent surgery because of the persistence of valvular vegetations after antibiotic therapy. The prognosis was good with 0% mortality. Conclusion: Infective endocarditis should be considered in the differential diagnosis of intravenous drug users presenting with various clinical scenarios. Echocardiography remains the main modality and should be used serially to facilitate early diagnosis. The successful management of a complicated case often requires the close cooperation of an infectious disease physician, a cardiologist, an addiction physician and occasionally a cardiac surgeon.
Highlights
Endocarditis, called infective endocarditis, is an infection and inflammation of the heart valves and the inner lining of the heart chambers, which is called the endocardium
Echocardiography identified vegetations (1 to multiple in case 3) that ranged in size from 2cm2 to 2.8cm2 (Figs. 1 and 2)
The first three cases had positive blood cultures for Staphylococcus aureus while the Infective Endocarditis Related to Intravenous
Summary
From a database of 35 subjects with endocarditis during five years, we made a retrospective analysis of data for four cases between the age of 24-33 years old which were intravenous drug users. From a database of 35 subjects with endocarditis, we studied four cases between age of 24-33 years old which were intravenous drug users. The records of these cases form the material for this analysis. We studied parameters as patient personal data (age, sex, educational level), risk factors, causative microorganism, number of positive blood cultures, duration of symptoms, type of valve involved, echocardiographic findings (vegetation site, vegetation size, complications); other radiological examinations results (electrocardiogram, chest radiograph, chest CT-scan); presence and type of embolic events; treatment and mortality. Detailed laboratory workup including complete blood count, Erythrocyte Sedimentation Rate (ESR), renal and liver function test and blood cultures were studied (Table 1)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
