Clinical outcomes of severe tricuspid valve infective endocarditis related to intravenous drug abuse – a case series

2021 ◽  
pp. 1-6
Author(s):  
Cheryl Zhiya Chong ◽  
Robin Cherian ◽  
Perryn Ng ◽  
Tiong Cheng Yeo ◽  
Lieng Hsi Ling ◽  
...  
Keyword(s):  
Drug Abuse ◽  
Infective Endocarditis ◽  
Clinical Outcomes ◽  
Tricuspid Valve ◽  
Case Series ◽  
Intravenous Drug ◽  
Intravenous Drug Abuse

scholarly journals Tricuspid valve infective endocarditis following intravenous administration of traditional and complementary medicine (T&CM)

2020 ◽  
pp. 201010582093957
Author(s):  
Raja Ezman Raja Shariff ◽  
Sazzli Kasim ◽  
Effarezan Abdul Rahman
Keyword(s):  
Drug Abuse ◽  
Infective Endocarditis ◽  
Complementary Medicine ◽  
Tricuspid Valve ◽  
Intravenous Administration ◽  
Intravenous Drug ◽  
Intravenous Drug Abuse ◽  
Rare Occurrence ◽  
Device Implantation ◽  
Healthcare Associated

Right-sided infective endocarditis (IE) is often linked to intravenous drug abuse and healthcare-associated procedures involving catheters and device implantation. We report a rare occurrence of right-sided IE secondary to intravenous use of traditional and complementary medicine (T&CM).

scholarly journals Torsades de Pointes in Intravenous Drug Abuse–Associated Infective Endocarditis

2018 ◽  
Vol 21 (6) ◽  
pp. E507-E512
Author(s):  
Sarah Eapen ◽  
Michael Firstenberg
Keyword(s):  
Drug Abuse ◽  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Drug Overdose ◽  
Heart Block ◽  
Torsades De Pointes ◽  
Conduction System ◽  
Intravenous Drug ◽  
Intravenous Drug Abuse ◽  
Tricuspid Valve Replacement

Intravenous drug abuse rates in the United States have increased exponentially in recent years. Ohio is one of 5 states with the highest age-adjusted drug overdose death rates, with drug overdose causing 39.1 of every 100,000 deaths. In patients who survive, the associated morbidity poses a significant public health burden. Infective endocarditis, defined as an infection of the endocardium of the heart, is a potentially lethal consequence of bacteremia related to intravenous drug abuse. Methicillin-sensitive Staphylococcus aureus (MSSA) is the most commonly implicated organism and may affect the tricuspid valve. Indications for surgery include failure of medical management, worsening embolization, heart failure, and arrhythmias—typically bradyarrhythmias from infectious extension into the conduction system. Vegetation size and type of infection, such as drug-resistance pattern, fungal infection, and presence of prosthetic material, are becoming known risk factors for complications. Studies have demonstrated that early surgery tends to have a better prognosis than delayed intervention. Established guidelines for right-sided surgery are slowly evolving. Tricuspid valve surgery is becoming more common in these cases, but there is known risk for heart block owing to proximity of the conduction system to the tricuspid valve annulus. If patients develop complete heart block postoperatively, pacemaker placement may be indicated. There may be reluctance to implantation because of the risk of device infection with infective endocarditis. In addition, many may recover conduction as infection and edema resolve. Generally, bradyarrhythmias are well tolerated. However, we present 2 cases of torsades de pointes related to post-tricuspid-valve-replacement bradyarrhythmia. Torsades de pointes is a potentially lethal form of polymorphic ventricular arrhythmia associated with QT interval prolongation. Post-tricuspid-valve- replacement mortality may be secondary to induced lethal ventricular arrhythmias.

scholarly journals Surgical treatment of infective endocarditis in intravenous drug abusers

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Alina Zubarevich ◽  
Marcin Szczechowicz ◽  
Anja Osswald ◽  
Jerry Easo ◽  
Arian Arjomandi Rad ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Drug Abuse ◽  
Infective Endocarditis ◽  
Mortality Rates ◽  
Blood Cultures ◽  
Intravenous Drug ◽  
Intravenous Drug Abuse ◽  
Enterococcus Species ◽  
Function Impairment

Abstract Background Despite current progress in antibiotic therapy and medical management, infective endocarditis remains a serious condition presenting with high mortality rates. It also is a life-threatening complication in patients with a history of chronic intravenous drug abuse. In this study, we analyzed our institutional experience on the surgical therapy of infective endocarditis in patients with active intravenous drug abuse. The aim of the study is to identify the predictive factors of mortality and morbidity in this subgroup of patients. Methods Between 2007 and 2020, a total of 24 patients (7 female, mean age 38.5 ± 8.7) presenting with active intravenous drug abuse underwent a surgical treatment for the infective endocarditis at out center. The primary endpoint was survival at 30th day after the surgery. The secondary composite endpoint included freedom from death, recurrent endocarditis, re-do surgery, and postoperative stroke during the follow-up period. Mean follow-up was 4.2 ± 4.3 years. Results Staphylococcus species was the most common pathogen detected in the preoperative blood cultures. Infection caused by Enterococcus species as well as liver function impairment were identified as mortality predictor factors. Logistic EuroSCORE and EusoSCORE-II were also predictive factors for mortality in univariate analysis. Survival at 1 and 3 years was 78 and 72% respectively. Thirty-day survival was 88%. 30-day freedom from combined endpoint was 83% and after 1 and 3 years, 69 and 58% of the patients respectively were free from combined endpoint. Five patients (20.8%) were readmitted with recurrent infective endocarditis. Conclusion In patients presenting with active intravenous drug abuse, treatment of infective endocarditis should be performed as aggressively as possible and should be followed by antibiotic therapy to avoid high mortality rates and recurrent endocarditis. Early intervention is advisable in patients with an infective endocarditis and enterococcus species in the preoperative blood cultures, liver function deterioration as well as cardiac function impairment. Attention should be also payed to addiction treatment, due to the elevated relapse rate in patients who actively inject drugs. However, larger prospective studies are necessary to support our results. As septic shock is the most frequent cause of death, new treatment options, e.g. blood purification should be evaluated.

Infective Endocarditis Due to Neisseria sicca and Associated With Intravenous Drug Abuse

1992 ◽  
Vol 85 (9) ◽  
pp. 929 ◽  
Author(s):  
GREGG A. VALENZUELA ◽  
THOMAS D. DAVIS ◽  
EDDY PIZZANI ◽  
DAVID MCGROARTY
Keyword(s):  
Drug Abuse ◽  
Infective Endocarditis ◽  
Intravenous Drug ◽  
Intravenous Drug Abuse ◽  
Neisseria Sicca

scholarly journals A Complicated Case ofSerratia marcescensInfective Endocarditis in the Era of the Current Opioid Epidemic

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Ho-Man Yeung ◽  
Brijaé Chavarria ◽  
Dariush Shahsavari
Keyword(s):  
Drug Abuse ◽  
Infective Endocarditis ◽  
Intravenous Drug ◽  
Intravenous Drug Abuse ◽  
Course Of Disease ◽  
Septic Emboli ◽  
Severe Aortic Regurgitation ◽  
History Of ◽  
Pain Symptoms ◽  
Complicated Nature

While bacteremia due toSerratia marcescensis not uncommon, it rarely causes infective endocarditis. We report an isolated case of a 53-year-old male with history of intravenous drug abuse who presented with multiple acute pain symptoms and was found to haveS. marcescensbacteremia with septic emboli in his spleen, brain, and testes, secondary to a large aortic vegetation, as well as aortic infective endocarditis with severe aortic regurgitation requiring aortic valve replacement. His course of disease was further complicated by epidural and psoas abscesses and a necrotic testicle requiring orchiectomy due to his ongoing intravenous drug abuse. This case is an atypical presentation ofS. marcescensinfection, as he had no overt signs of infection such as fever or significant leukocytosis that are typical of bacteremia, and it also highlights the severity and complicated nature ofS. marcescens-infective endocarditis.

scholarly journals A Case Series and Review of Bacillus Cereus Endocarditis from India

2018 ◽  
Vol 12 (1) ◽  
pp. 28-33
Author(s):  
Anusha Gopinathan ◽  
Anil Kumar ◽  
Amitabh C. Sen ◽  
Srisruthy Sudha ◽  
Praveen Varma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Drug Abuse ◽  
Bacillus Cereus ◽  
Case History ◽  
Case Series ◽  
Intravenous Drug ◽  
Intravenous Drug Abuse ◽  
Review Of The Literature ◽  
Gram Positive ◽  
First Report

Introduction: Bacillus cereus is a gram positive bacilli found commonly in the soil and environment. It is a bacteria rarely associated with endocarditis. Case History: Intravenous drug abuse, presence of valvular defects, pacemakers, immunodeficiency are some of the known risk factors for B.cereus endocarditis. We present here a case series of two patients with B.cereus endocarditis along with a review of the literature. Conclusion: This is the first report of B.cereus endocarditis from India to the best of our knowledge.

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