Findings on doppler echocardiography in asymptomatic intravenous heroin users

Pons-Lladó, Ġuillem; Carreras, Francesc; Borrfás, Xavier; Cadafalch, Josep Puig i; Fuster, Montserrat; Guardia, Josep; Casas, Miquel

doi:10.1016/0002-9149(92)91312-r

Cited by 24 publications

(13 citation statements)

References 15 publications

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“…Valvular abnormalities are a well-established risk factor for chronic Q fever endocarditis and may be more prevalent among injection drug users. [28][29][30][31][32][33] Additionally, injection drug users are at increased risk for infective endocarditis caused by organisms other than C. burnetii, which can result in valvular damage and increased risk for recurrent endocarditis. [34][35][36] Concerns about IDU history among community members included the potential for asymptomatic, undetected valvular abnormalities at a rate higher than that of a non-IDU population and the possibility for future valvular damage in the setting of IDU relapse, either of which could increase the risk for Q fever endocarditis.…”

Section: Discussionmentioning

confidence: 99%

Coxiella burnetii Infection in a Community Operating a Large-Scale Cow and Goat Dairy, Missouri, 2013

Biggs

Turabelidze

Pratt

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Coxiella burnetii is a zoonotic pathogen that causes Q fever in humans and is transmitted primarily from infected goats, sheep, or cows. Q fever typically presents as an acute febrile illness; however, individuals with certain predisposing conditions, including cardiac valvulopathy, are at risk for chronic Q fever, a serious manifestation that may present as endocarditis. In response to a cluster of Q fever cases detected by public health surveillance, we evaluated C. burnetii infection in a community that operates a large-scale cow and goat dairy. A case was defined as an individual linked to the community with a C. burnetii phase II IgG titer ≥ 128. Of 135 participants, 47 (35%) cases were identified. Contact with or close proximity to cows, goats, and their excreta was associated with being a case (relative risk 2.7, 95% confidence interval 1.3-5.3). Cases were also identified among individuals without cow or goat contact and could be related to windborne spread or tracking of C. burnetii on fomites within the community. A history of injection drug use was reported by 26/130 (20%) participants; follow-up for the presence of valvulopathy and monitoring for development of chronic Q fever may be especially important among this population.

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Section: Discussionmentioning

confidence: 99%

Coxiella burnetii Infection in a Community Operating a Large-Scale Cow and Goat Dairy, Missouri, 2013

Biggs

Turabelidze

Pratt

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…Injection of particulate matter (such as talc) along with illicit drugs and its repetitive use produces cumulative subclinical damage to the tricuspid valve 1 2. In the process of drug injection, patients may also inject bacteria or fungi present on the surface of the skin, in the drug itself, or in diluents, fillers, or filters used to prepare drugs for injection 1.…”

Section: Discussionmentioning

confidence: 99%

A chest wall pulsating mass

et al. 2015

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SUMMARYA 34-year-old HIV-positive man with intravenous drug addiction presented with a 2-week history of fever and a pulsatile presternal mass; 2 weeks prior he had suffered a traumatic sternal fracture. The CT scan showed a bulky abscess with presternal and retrosternal extension that contacted the heart (which explained its pulsatile effect) and pulmonary necrotising lesions. Drainage of the thoracic wall abscess was performed, and antibiotics (flucloxacillin plus gentamicin) were started on the presumption of staphylococcal bacteraemia given the patient's intravenous drug habit. Blood cultures and culture of the aspirated pus confirmed growth of methicillin-sensitive Staphylococcus aureus; transoesophageal echocardiography showed endocarditis of the tricuspid valve. We therefore assumed pulmonary septic embolisation from right-sided endocarditis and acute sternal osteomyelitis, and the patient was treated for 6 weeks with clinical resolution. BACKGROUND

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“…13,29 Moreover, specific substances that may be injected with IV drugs, such as talc, generate direct endothelial damage and therefore predispose to infection. 16,30 Also, particulate matter up to 10 mm in size may cross the pulmonary circulation and damage the mitral or aortic valve.…”

Section: Epidemiologymentioning

confidence: 99%

Right-Sided Infective Endocarditis and Pulmonary Infiltrates

Chahoud

Yakan

Saad

et al. 2016

Cardiology in Review

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Sixty years after its initial description, right-sided infective endocarditis (RSIE) still poses a challenge to all medical practitioners. Epidemiological data reveal a rising incidence attributable to the global surge in the number of intravenous drug users and the increased use of central vascular catheters and implantable cardiac devices. RSIE differs from left-sided infective endocarditis in more than just the location of the involved cardiac valve. They have different clinical presentations, diagnostic findings, and prognoses; hence, they require different management strategies. Cardiac murmurs and systemic emboli are usually absent in RSIE, whereas pulmonary embolism and its related complications dominate the clinical picture. Diagnostic delay of RSIE is secondary to the similarity in its initial presentation to other entities. Complications may ensue as a result of this delay. Diagnosis can be initially confirmed by using transthoracic echocardiography, except in patients with implanted cardioverter defibrillator, where a transesophageal echocardiogram is necessary. Various factors may increase mortality and morbidity in RSIE such as tricuspid valve vegetation size, fungal etiology, and low CD4 cell count in HIV patients. Oxacillin and vancomycin had been the traditionally used agents for the treatment of methicillin-susceptible and methicillin-resistant Staphylococcus aureus, respectively. More recently, daptomycin has shown promising results, which has led to its Food and Drug Administration (FDA) approval for the treatment of S. aureus bacteremia and associated RSIE. The aim of this article is to provide a comprehensive update on RSIE including epidemiology, pathogenesis, microbiology, diagnosis, management, and prognosis.

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Findings on doppler echocardiography in asymptomatic intravenous heroin users

Cited by 24 publications

References 15 publications

Coxiella burnetii Infection in a Community Operating a Large-Scale Cow and Goat Dairy, Missouri, 2013

Coxiella burnetii Infection in a Community Operating a Large-Scale Cow and Goat Dairy, Missouri, 2013

A chest wall pulsating mass

Right-Sided Infective Endocarditis and Pulmonary Infiltrates

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