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[Cerebral infarction due to bacterial emboli associated with methamphetamine abuse]
M Imanishi1, T Sakai, A Nishimura
1Department of Emergency and Critical Care Medicine, Nara Medical University, Japan.
Abstract:
The number of stimulant-drug addicts has recently been on the rise again, and they are being increasingly encountered in the emergency room. There are also frequent reports of cerebrovascular disorders complicating drug toxicity. These cerebrovascular disorders have included subarachnoid hemorrhage, intracranial hematoma, and a few cases of cerebral infarction. Here, we report the case of a 37-year-old male with drug toxicity, consciousness disorder, and hyperthermia. He was in a coma with a temperature of 43.1 degrees C and blood pressure of 58/35 mmHg when brought to our hospital. His condition worse rapidly deteriorated, and he died the same day. Cerebral infarction caused by gram-positive bacillus embolism, not necrotizing angiitis, was found at autopsy. Because drug addicts, especially stimulant-drug addicts, tend to inject themselves drug under unsanitary conditions, the possibility of this type of complication is always present. This is the first such case ever reported, and is therefore regarded as a rare complication of stimulant-drug intoxication.
Insights
Stimulant drug abuse is rising, leading to emergency room visits and severe cerebrovascular events. A rare case of cerebral infarction due to gram-positive bacillus embolism in a stimulant user highlights this risk.
Area of Science:
- Neurology
- Toxicology
- Infectious Diseases
Background:
- Increasing prevalence of stimulant drug abuse presents significant public health challenges.
- Cerebrovascular disorders are known complications of drug toxicity, including hemorrhage and infarction.
- Emergency departments frequently encounter patients with stimulant-induced toxicity.
Observation:
- A 37-year-old male presented with severe stimulant drug toxicity, hyperthermia (43.1°C), and profound hypotension (58/35 mmHg).
- The patient rapidly deteriorated and died on the same day.
- Autopsy revealed cerebral infarction attributed to gram-positive bacillus embolism.
Findings:
- The cause of cerebral infarction was identified as gram-positive bacillus embolism, distinct from necrotizing angiitis.
- This represents the first reported case of cerebral infarction due to gram-positive bacillus embolism in the context of stimulant drug intoxication.
- Unsanitary injection practices among stimulant users increase the risk of such embolic events.
Implications:
- This case underscores a rare but potentially fatal complication of stimulant drug abuse.
- Highlights the importance of considering infectious embolic events in patients with stimulant toxicity and neurological deficits.
- Emphasizes the need for harm reduction strategies and awareness of infectious risks associated with non-sterile drug use.