921Prevalence of Hepatitis C Infection and Epidemiology of Infective Endocarditis in Intravenous Drug Users in Central Kentucky

Introductory Chapter: Endocarditis

“…The role of infected needles, infected drugs, skin contamination, or some combination all contribute to the risk for endocarditis. Acute infections are further challenged by other substantial comorbidities, such as untreated Hepatitis B/C and the Human Immunodeficiency Virus (HIV) [22]. As a consequence of long-standing narcotic use/abuse, infected patients will often chronic pain syndromes and drug tolerance that can make symptom management difficult.…”

Introductory Chapter: Introduction to Advanced Concepts in Endocarditis

“…While it is unclear if it is infected needles, skin contamination, or infected drugs being injected-or a combination of events-the consequences are the same. In addition, as a function of their substance abuse, often these patients present with underlying, and often untreated, hepatitis B, hepatitis C, and the human immunodeficiency virus (HIV) [33]. These patients often have chronic pain syndromes and high levels of tolerance to narcotics associated with their drug addictions, not to mention associated personality and psychological disorders, all of which challenge the short-and long-term care and management options for this population.…”

Introductory Chapter: Endocarditis - A Diagnostic and Therapeutic Challenge

“…Patients who present with infections also have other acquired comorbidities associated with their substance abuse that challenge their management and long-term prognosis. Hepatitis B and C as well as human immunodeficiency virus are often encountered in this patient population [25]. Chronic pain syndromes as well as their underlying drug addiction and associated personality and psychological disorders not only makes this population difficult to manage in the hospital setting but also raises the concern of long-term compliance with medical therapies.…”