[Infective endocarditis in intravenous drug users. Study of 34 cases]

Infective endocarditis (IE) in injection drug users (IDU) have a special etiologic, epidemiological and clinical characteristics different to IE in the general population. The clinical and evolutive features of a group of IE in IVD are reported.

A retrospective analysis was made of 34 episodes (24 patients) of IE in IDU in the Catagena Area (Murcia, Sapin).

A total 34 episodes, 18 was males (75%) and 6 (25%) females with a age media of 26.1 years (DE, 4.3). Eighty-four percents were infected with human immunodeficiency virus. The location of IE was right-side in 26 (73%), left-side in 7 cases (18%) and right-left in one (2%). Staphylocococcus aureus was isolated in 31 cases (91%), it was meticillin-resistant in 4 cases (13%); Pseudomonas aeruginosa, and Streptococcus equisimilis was isolated in one case each. Fever was present in 33 patients (97%) and more than half were cough, pleuritic chest pain and expectoration. Twenty-five patients with right IE has chest X-ray abnormal, specially nodules-infiltrates pulmonary. Vegetations were not observe in 7 (21%) occasions by transthoracic echocardiography. In six of 8 patients with left-side IE present a cerebri embolisms. Two patients with left IE death (21%). The rate of successful therapy in the right-side IE treated during 2 or 4 weeks were 100%.

The IE in IDU is a entity produced mainly by S. aureus, affect preferentially a right-side cavities and the prognosis is generally good.