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Published on: November 4, 2015
[Pulmonary damage caused by right side infective endocarditis in intravenous drug users]
1Department of Respiratory Disease, the First People's Hospital of Shunde, Shunde 528300, China.
Objective:
To highlight the understanding of pulmonary damage caused by right side infective endocarditis (RIE).
Methods:
28 intravenous drug users with pulmonary damage caused by RIE from 1994 to 2000 were reviewed with chest roentgenogram, chest B-ultrasound, blood gas analysis and sputum cultures.
Results:
100% (28/28) cases with RIE showed pulmonary damage, in which cough 100% (28/28), expectoration 71% (20/28), breathlessness 64% (18/28), pleuritic chest pain 57% (16/28), hemoptysis 36% (10/28) rales were present in 20 cases (71%) (20/28). By chest X-rays 82% (23/28) patients showed pulmonary infiltrative lesion, 21% (6/28) showed multiple thin wall cystic lesion. manifestations for pulmonary embolism were shown in 6 cases (21%). Pleural effusion was confirmed by chest B-ultrasound in 6 cases (21%). Respiratory failure present in 4 cases (4/28). Positive rate of sputum cultures was 54% (15/28). The prognosis for twenty-three patients (82%) when treated with the regimen of 4 to 6 weeks of parenteral antibiotics was good, Five patients (18%) underwent surgery, and two of them died.
Conclusion:
The pulmonary damage by RIE should be paid more attention to for avoiding misdiagnosis.
Insights
Right-sided infective endocarditis (RIE) frequently causes significant pulmonary damage in intravenous drug users. Prompt diagnosis and treatment with antibiotics are crucial for good outcomes, though surgery may be necessary in some cases.
Area of Science:
- Cardiology
- Pulmonology
- Infectious Diseases
Background:
- Right-sided infective endocarditis (RIE) is a serious infection affecting the heart's right side.
- Intravenous drug use is a significant risk factor for developing RIE.
- Pulmonary complications secondary to RIE can be severe and are often overlooked.
Purpose of the Study:
- To elucidate the spectrum of pulmonary damage associated with RIE.
- To emphasize the importance of recognizing RIE-induced lung injury to prevent misdiagnosis.
- To evaluate treatment outcomes for patients with RIE and pulmonary involvement.
Main Methods:
- Retrospective review of 28 intravenous drug users diagnosed with RIE and pulmonary damage between 1994 and 2000.
- Utilized chest roentgenogram, chest B-ultrasound, blood gas analysis, and sputum cultures for assessment.
- Clinical data and treatment responses were analyzed.
Main Results:
- All 28 patients (100%) with RIE exhibited pulmonary damage, with common symptoms including cough (100%), expectoration (71%), and dyspnea (64%).
- Radiographic findings revealed pulmonary infiltrative lesions (82%), cystic lesions (21%), and signs of pulmonary embolism (21%).
- Treatment with 4-6 weeks of parenteral antibiotics resulted in a good prognosis for 82% of patients; 18% required surgery, with two fatalities.
Conclusions:
- Pulmonary damage is a consistent manifestation of RIE in this population.
- Increased clinical awareness is necessary to avoid misdiagnosis of RIE-related lung pathology.
- Early and appropriate antibiotic therapy is effective in managing RIE-induced pulmonary complications.
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