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.

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 The increasing frequency of intravenous drug abuse–associated spinal epidural abscesses: a case series

2019 ◽  
Vol 46 (1) ◽  
pp. E4 ◽  
Author(s):  
Anthony M. DiGiorgio ◽  
Rachel Stein ◽  
Kevin D. Morrow ◽  
Jared M. Robichaux ◽  
Clifford L. Crutcher ◽  
...  
Keyword(s):  
Drug Abuse ◽  
Neurological Deficit ◽  
The United States ◽  
Intravenous Drug ◽  
Intravenous Drug Abuse ◽  
Medical Attention ◽  
Complication Rates ◽  
Opioid Prescribing ◽  
Spinal Epidural

OBJECTIVEFew studies have been published specifically examining intravenous drug abuse (IVDA)–associated spinal epidural abscesses (SEAs), an unfortunate sequela of the opioid crisis in the United States. Here, the authors examined a series of patients with IVDA-associated SEAs in order to shed light on this challenging disease entity.METHODSThis study is a retrospective chart review of patients presenting with IVDA-associated SEAs at the authors’ institution from 2013 to 2018, spanning the statewide implementation of opioid-prescribing restrictions.RESULTSA total of 45 patients presented with IVDA-associated SEAs; 46.5% presented with a neurological deficit. Thirty-one patients underwent surgery for neurological deficit, failure of medical therapy, or both. Nineteen surgical patients underwent a fusion procedure along with decompression. The complication rate was 41.9%, and the mortality rate was 6.7%. The average length of stay was 27.6 days. Patients who underwent surgery within 24 hours of onset of neurological symptoms trended toward more improvement in their American Spinal Cord Association Impairment Scale grade than those who did not (0.5 vs −0.2, p = 0.068). Methicillin-resistant Staphylococcus aureus was isolated as the causative pathogen in 57.8% of patients. Twenty-three patients (51.5%) kept their scheduled clinic follow-up appointments. Of the fusion patients with adequate follow-up, 5 showed bony arthrodesis and 3 had pseudarthrosis. The rate of IVDA-associated SEAs increased after opioid-prescribing restrictions were put in place, from 0.54 cases per month to 1.15 cases per month (p = 0.017).CONCLUSIONSPatients with IVDA-associated SEAs are challenging to treat, with high complication rates and poor follow-up. This disease is increasing in frequency, and opioid-prescribing restrictions did not slow that rise. Community outreach to promote prevention, early medical attention, and medication compliance would benefit this largely publicly funded patient population.

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.

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 Uncommon Pathogen, Lactobacillus, Causing Infective Endocarditis: Case Report and Review

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Muhannad Antoun ◽  
Yousef Hattab ◽  
Fadi-Al Akhrass ◽  
Leigh Danielle Hamilton
Keyword(s):  
Case Report ◽  
Drug Abuse ◽  
Infective Endocarditis ◽  
Dental Caries ◽  
Opportunistic Infections ◽  
Case Reports ◽  
Intravenous Drug ◽  
Intravenous Drug Abuse ◽  
Common Pathogen

Lactobacillus is not a common pathogen; however, it can contribute to opportunistic infections such as infective endocarditis (IE). Nonetheless, it has been reported as case reports in correlation with increased probiotic use, dental caries, and intravenous drug abuse.

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