scholarly journals Intravascular Talcosis due to Intravenous Drug Use Is an Underrecognized Cause of Pulmonary Hypertension

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Christopher C. Griffith ◽  
Jay S. Raval ◽  
Larry Nichols
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Drug Use ◽  
Intravenous Drug ◽  
Granulomatous Disease ◽  
Intravenous Drug Use ◽  
Left Heart ◽  
Foreign Material ◽  
History Of ◽  
The Right

Intravenous injection of illegal drugs or medications meant for oral administration can cause granulomatous disease of the lung. This intravascular talcosis results in pulmonary fibrosis and pulmonary hypertension. Nine cases of histologically confirmed intravascular talcosis were reviewed with specific attention given to the clinical histories in these patients. Five autopsy cases were included in this series with detailed investigation in the anatomic features associated with intravascular talcosis and pulmonary hypertension. All nine patients showed perivascular and/or intravascular deposition of polarizable foreign material in their lungs. Intravascular talcosis as a result of previous intravenous drug use was not clinically suspected in any patient despite clinically diagnosed pulmonary hypertension in five. All patients showed dilatation of the right and left heart, but none had dilatation of the aortic valve. Congestive heart failure with hepatosplenomegaly was also common. We conclude that intravascular talcosis is an underdiagnosed cause of pulmonary hypertension in patients with known history of intravenous drug use.

Pulmonary hypertension in patients with a history of intravenous drug use

2019 ◽  
Vol 35 (6) ◽  
pp. 1097-1101
Author(s):  
Michael McGee ◽  
Nicholas Whitehead ◽  
Scott Twaddell ◽  
Nicholas Collins
Keyword(s):  
Pulmonary Hypertension ◽  
Drug Use ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
History Of

scholarly journals GAGAL JANTUNG KIRI DAN HIPERTENSI PULMONAL

2017 ◽  
Vol 1 (1) ◽  
pp. 9-21
Author(s):  
Djanggan Sargowo
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Ejection Fraction ◽  
Right Ventricular Dysfunction ◽  
Left Heart ◽  
Left Heart Failure ◽  
Non Invasive ◽  
Hemodynamic Variables ◽  
History Of ◽  
The Right

In patients with left heart failure, pulmonary hypertension and right ventricular dysfunction is a common condition and has important implications in the development of disease, disability and death, so it required special attention. Pulmonary hypertension is the most common form with approximately 65-80% of cases. Although today is already highly developed understanding of the pathophysiology and clinical assessment, as well as setting the hemodynamic definition and classification of pulmonary hypertension in left heart failure, but the interrelation hemodynamics in pulmonary hypertension combination of pre- and post-capillary is still very complex, and there is no evidence-based recommendations the handling of pulmonary hypertension is left heart failure. Here, we will discuss the prevalence and significance of pulmonary hypertension and cardiac dysfunction Right in patients with both heart failure with ejection fraction decreased, as well as heart failure with ejection fraction, as well as provides an overview of the pathophysiology of the complex due to the interaction of cardiopulmonary left heart failure, which can supports the evolution of the phenotype of the left ventricle into the right ventricle phenotype through the travel history of heart failure. Next, we will discuss fenoitp pulmonary hypertension by combining the clinical context, the assessment of non-invasive and invasive hemodynamic variables in a structured diagnostic assessment.

A Man with a History of Intravenous Drug Use and Diffuse Small Nodular Lung Opacities on Imaging

2021 ◽  
Vol 18 (12) ◽  
pp. 2079-2083
Author(s):  
Bryton E. Perman ◽  
Ian Jackson ◽  
Ali Nayfeh ◽  
Shraddha Narechania
Keyword(s):  
Drug Use ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
History Of

scholarly journals THYROID ABSCESS AFTER INJECTION OF HEROIN INTO THE NECK COMPLICATED BY THYROID STORM

2020 ◽  
Vol 6 (4) ◽  
pp. e183-e188
Author(s):  
Christine Mathai ◽  
Anthony Coppola ◽  
Cherie Lisa Vaz
Keyword(s):  
Drug Use ◽  
Reference Range ◽  
Free Thyroxine ◽  
Intravenous Drug ◽  
Thyroid Storm ◽  
Antithyroid Drugs ◽  
Intravenous Drug Use ◽  
Surgical Drainage ◽  
Thyroid Abscess ◽  
The Right

Objective: Our objective is to present a case of thyroid abscess complicated by thyroid storm secondary to intravenous drug use. Cases of thyroid abscess causing thyrotoxicosis are rare. This is the first report of thyroid abscess from intrathyroidal injection of illicit drugs resulting in thyroid storm. Methods: We used biochemical evaluation, computed tomography (CT), and ultrasound to assess the thyroid abscess. Treatment included antithyroid drugs, steroids, antibiotics, and surgical drainage. Results: A 28-year-old female presented with neck pain and fever after injecting heroin into her neck. CT showed bilateral thyroid abscesses measuring 3.0 cm on the left and 2.0 cm on the right. Thyroid-stimulating hormone (TSH) was 0.40 mIU/L (reference range is 0.34 to 5.60 mIU/L). She left against medical advice, then returned with worsening symptoms. CT showed multiloculated, bilateral thyroid abscess measuring 8.6 cm on the left and 5.3 cm on the right. She suffered a cardiac arrest and was resuscitated. Her white blood cell count was 25.9 × 103 cells/mL, TSH <0.01 mIU/L, free thyroxine was 4.25 ng/dL (reference range is 0.89 to 1.76 ng/dL), triiodothyronine was 96 ng/dL (reference range is 70 to 204 ng/dL), and thyroid-stimulating immunoglobulin was <89% (reference range is <140%). She had fever, tachycardia, heart failure, and elevated bilirubin confirming a diagnosis of thyroid storm by Japan Thyroid Association criteria and Burch-Wartofsky score. She was treated with propylthiouracil, hydrocortisone, and antibiotics. Two days later her TSH was <0.005 mIU/L, free thyroxine was 3.06 ng/dL, and triiodothyronine was 62.0 ng/dL. Ultrasound showed enlarged, heterogeneous thyroid with loculated fluid collections. Following surgical abscess drainage, her thyroid function normalized and progressed to hypothyroidism. Conclusion: We conclude that thyroid abscess can be a life-threatening complication of intravenous drug use as it can precipitate thyroid storm. Along with surgical drainage of the abscess, successful management includes antithyroid drugs, antibiotics, and steroids to control thyrotoxicosis, infection, and inflammation.

scholarly journals BacillusPanophthalmitis with Posterior Extension to the Prechiasmatic Optic Nerve

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
James E. Kasenchak ◽  
Benjamin P. Hale ◽  
Thomas W. Wilson ◽  
Gregory M. Notz
Keyword(s):  
Optic Nerve ◽  
Drug Use ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Eye Pain ◽  
Elevated Intraocular Pressure ◽  
History Of ◽  
Posterior Extension ◽  
Repeat Imaging

A rare case ofBacilluspanophthlamitis with extension to the prechiasmatic optic nerve secondary to hematogenous spreading after intravenous drug use is presented. A 27-year-old man with a recent history of trauma to the left eye presented with severe left eye pain following a binge of intravenous drug use. Visual acuity (VA) was LP. On examination he had chemosis, proptosis, elevated intraocular pressure, and a complete hyphema. CT-scan identified preseptal swelling, but no evidence of any posterior extension of the anterior process or orbital fractures. Topical and systemic therapy were initiated. On follow-up clinical examination less than 12 hours after presentation he had signs of a keratitis with worsening ophthalmoplegia and repeat imaging demonstrated posterior extension to the prechiasmatic optic nerve. Shortly after the cornea ruptured with cultures growingBacillus. The patient underwent enucleation and has had no further progression of infection. To the best of our knowledge, this is the first report ofBacilluspanophthalmitis presenting with signs of trauma with posterior extension to the prechiasmatic optic nerve.

Thrombocytopenia in a bisexual adolescent male with a history of intravenous drug use

1987 ◽  
Vol 8 (5) ◽  
pp. 449-451
Author(s):  
Sanford M. Melzer ◽  
Michael A. Weiner ◽  
Ramon J.C. Murphy ◽  
Leslie R. Jaffe
Keyword(s):  
Drug Use ◽  
Intravenous Drug ◽  
Adolescent Male ◽  
Intravenous Drug Use ◽  
History Of
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