Abstract
Management of a patient who inject drugs, presenting with right-sided infective endocarditis
Highlights
Patients with intravenous drug user (IDU)-induced Right-sided infective endocarditis (RSIE) are often young, with a history of infectious diseases such as hepatitis B, hepatitis C or HIV infection and psychiatric pathologies associated with substance abuse, all of which often complicated by lack of social and family support
Patients with IDU-induced RSIE are often young, with a history of infectious diseases such as hepatitis B, hepatitis C or HIV infection and psychiatric pathologies associated with substance abuse, all of which often complicated by lack of social and family support
RSIE treatment consists of intravenous antibiotic therapy, together with surgical intervention
Summary
Mainly due to the high recurrence rate of drug use and the risk of RSIE of prosthetic valves [2,3,4,5]. Serology for HIV1 / 2, HBV, HCV was negative The patient stated he has benefited from the national program of free distribution of single-use syringes for IDU, as part of the strategy aimed to prevent the transmission of parenteral infections. This might have contributed to him not being infected to HIV1 / 2, HBV or HCV. The patient was discharged on request, after 42 days of hospitalization and 7 days of normal body temperature, with CRP and leukocytes at a stationary level of 9 mg/dl, respectively 13,000/μl and persistent, mobile vegetations with maximum sizes 8.6/9.2 mm, mild to severe tricuspid regurgitation, potentially complicated with anterior cusp prolapse. A recent meta-analysis found that conservative treatment in presence of S. aureus infection was associated with significantly increased mortality – 51% compared to conservative and surgical treatment – 31% [8]
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