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Unusual pathogens in narcotic-associated endocarditis.

S Szabo¹, J P Lieberman, Y A Lue

¹Department of Medicine, Lincoln Hospital, Bronx, New York.

Reviews of Infectious Diseases

|May 1, 1990

Summary

Three intravenous drug users developed endocarditis from rare bacteria. Human immunodeficiency virus infection may contribute to these unusual cases, presenting with fever and embolic events unresponsive to antibiotics.

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Area of Science:

Infectious Diseases
Cardiology
Microbiology

Background:

Endocarditis is a serious infection, often associated with intravenous drug abuse.
Staphylococcus aureus is the most common cause of endocarditis in this population.

Observation:

Three cases of endocarditis caused by Corynebacterium xerosis, Neisseria subflava, and Neisseria flavescens in intravenous drug users were observed.
These specific bacterial causes are rarely reported in association with narcotic addiction.
Two patients presented with clinical signs of human immunodeficiency virus infection.

Findings:

Patients exhibited poor response to antibiotic therapy, persistent fever, and significant embolic events.
The occurrence of these three unusual cases within a nine-month period is notable.

Implications:

Human immunodeficiency virus infection might play a role in the development of endocarditis caused by these uncommon pathogens.
These findings highlight the need to consider less common bacteria and potential co-infections in intravenous drug users with endocarditis.

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