Lung damage in drug addicts who inject drugs parenterally.

Abstract

Objective. Тo study the characteristics of lung disease at parenteral drug users. Materials and methods. 69 patients - parenteral drug users were under direct observation, all were diagnosed with pneumonia on admission: 17 (24,6%) with non-severe (<3 points on the CURB-65); 52 (75.4%) with severe pneumonia, 14 (26,9%) patients were initially hospitalized in the ICU. Results. The average age was 32.8±6.9 years, males - 53 (76,8%). HIV infection was verified in 59 (85.5%) patients (11 women and 48 men). Polydrug use was defined in 31 (44.9%), desomorphine and heroin - in 27 (39,2%), amphetamine - in 11 (15.9%) patients. Experience of drug addiction ranged from 7 months to 20 years. 64 patients had viral hepatitis (В, С, В+С), 18 (26,1%) patients - respiratory tuberculosis, 24 (34,8%) - infective endocarditis (IE). HIV-infection of the II (7 patients) and III (10 patients) stage was verified in all patients with non-severe pneumonia (SIRS - 2,3±1,0). 21 patients were diagnosed severe pneumonia (scores by SOFA - 15,7 ±7,6; by APACHE II - 26,6 ±11,9). Septic pulmonary embolism (SPE) was diagnosed in 22 patients, with signs of acute thrombophlebitis of the proximal veins and typical clinic-radiological data. HIV infection of the IV stage (CD4+ <200 cells/μl, copies of HIV RNA >100,000 per ml), leukopenia and Pneumocystis pneumonia were diagnosed in 9 patients. Conclusion. Lung damage at parenteral drug users may manifest by clinic of community acquired non-severe pneumonia, severe pneumonia, including sepsis-associated, septic pulmonary embolism, secondary manifestations of HIV infection. When the diagnosis: The type of drug, the injection site, the presence of impurities of talc, a significant number of HIV-infected patients, patients with hepatitis, tuberculosis, heart failure should be considered at diagnostics.