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[Infective endocarditis and drug addiction]
A De Rosa1, G Botvinik, S Kaufman
1División Cardiología y Laboratorio, Hospital Juan A. Fernández, Buenos Aires.
A total of 103 patients (P) with infectious endocarditis (IE) were treated during the period 1982-1993; 72% of them were male. Mean age was 46.4 (SD 19.7). Eighteen patients were intravenous drug addicts (D) (17.5%). The first case of drug addiction in the IE group was seen in 1986; since then, there was a steady increase of this condition, reaching 50% of all cases. The average age of D patients was 28.17 +/- 8.15 years significantly lower than that corresponding to non-drug addicts (ND), 48.64 +/- 19.5 (p < 0.00001). The infection was located mainly in the left heart of the ND (93%), and in the right heart of the D (78%), the difference being statistically significant. All the cases of left IE occurred on previously damaged valves. Right location in ND was found in all cases in immunosuppressed individuals being treated for systemic diseases, except in one patient having an endocavitary pacemaker. No differences were found between ND and D with regard to the presence of fever, cutaneous manifestations, splenomegaly or cerebrovascular accident. Differences were noted, however, in the case of respiratory involvement, which showed a significantly higher frequency in D (38.9% versus 12.9%; p < 0.014). Blood cultures were positive in 81.6% of the total number of patients, no difference being found between the two groups. Staphylococcal infections were predominant in D (44%) and streptococcal infections in ND (48%), the difference being statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)
A total of 103 patients (P) with infectious endocarditis (IE) were treated during the period 1982-1993; 72% of them were male. Mean age was 46.4 (SD 19.7). Eighteen patients were intravenous drug addicts (D) (17.5%). The first case of drug addiction in the IE group was seen in 1986; since then, there was a steady increase of this condition, reaching 50% of all cases. The average age of D patients was 28.17 +/- 8.15 years significantly lower than that corresponding to non-drug addicts (ND), 48.64 +/- 19.5 (p < 0.00001). The infection was located mainly in the left heart of the ND (93%), and in the right heart of the D (78%), the difference being statistically significant. All the cases of left IE occurred on previously damaged valves. Right location in ND was found in all cases in immunosuppressed individuals being treated for systemic diseases, except in one patient having an endocavitary pacemaker. No differences were found between ND and D with regard to the presence of fever, cutaneous manifestations, splenomegaly or cerebrovascular accident. Differences were noted, however, in the case of respiratory involvement, which showed a significantly higher frequency in D (38.9% versus 12.9%; p < 0.014). Blood cultures were positive in 81.6% of the total number of patients, no difference being found between the two groups. Staphylococcal infections were predominant in D (44%) and streptococcal infections in ND (48%), the difference being statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)