[Bacterial endocarditis in drug addicts. 20 cases (author's transl)]

The authors report on 20 cases of bacterial endocarditis in heroin addicts, i.e. 9.1% of all cases of that infection observed over an 8-year period. The disease involved the tricuspid valve in 80% of the cases and was due to Staphylococcus aureus in the same percentage of patients. Diagnosis was sometimes difficult in the right heart but was confirmed by repeated echocardiography. Combined antibiotic therapy was administered for 45 days. Only one patient died of relapsing endocarditis on valve prosthesis. Six patients were operated upon: 2 for cardiac failure, 2 for persistent infection and 2 for recurrent pulmonary embolism. Three patients underwent valve replacement and 3 tricuspidectomy. The persistence of pulmonary embolism after eradication of the infecting organism does not seem to warrant surgery.