Prospective Study of Infective Endocarditis among Injection Drug Users

Wilson, Lucy; Thomas, David L.; Astemborski, Jacqueline; Freedman, Terri L.; Vlahov, David

doi:10.1086/340827

Cited by 132 publications

(71 citation statements)

References 20 publications

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“…PRAWEJ CZĘŚCI SERCA Infekcyjne zapalenie wsierdzia prawej komory przyczynia się do wystąpienia 5-10% wszystkich przypadków IZW [419,420]. Chociaż może wystąpić u pacjentów z wszczepionym układem stymulującym serce, ICD, centralnym wkłuciem żylnym lub CHD, najczęściej dotyczy osób uzależnio-nych od dożylnych narkotyków, szczególnie pacjentów ze współistniejącym zakażeniem ludzkim wirusem niedoboru odporności (HIV) lub pacjentów leczonych immunosupresyjnie [420][421][422].…”

Section: Infekcyjne Zapalenie Wsierdziaunclassified

“…Chociaż może wystąpić u pacjentów z wszczepionym układem stymulującym serce, ICD, centralnym wkłuciem żylnym lub CHD, najczęściej dotyczy osób uzależnio-nych od dożylnych narkotyków, szczególnie pacjentów ze współistniejącym zakażeniem ludzkim wirusem niedoboru odporności (HIV) lub pacjentów leczonych immunosupresyjnie [420][421][422]. Dominującym czynnikiem etiologicznym zakażenia jest S. aureus (60-90% przypadków) [419,423], z narastającą częstością występowania szczepów metycylinoopornych [414].…”

Section: Infekcyjne Zapalenie Wsierdziaunclassified

“…U pacjentów zakażonych HIV liczba limfocytów CD4 < 200 komórek/μl miała dużą wartość prognostyczną [420,421].…”

Section: Rokowanie I Leczenieunclassified

See 2 more Smart Citations

2015 ESC Guidelines for the management of infective endocarditis

Habib¹,

Lancellotti

Antunes³

et al. 2015

Kardiol Pol

132

212

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Section: Infekcyjne Zapalenie Wsierdziaunclassified

See 1 more Smart Citation

2015 ESC Guidelines for the management of infective endocarditis

Habib¹,

Lancellotti

Antunes³

et al. 2015

Kardiol Pol

132

212

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“…The incidence of endocarditis in injection drug users is estimated to be 1.5-3.3 cases per 1000 injection drug users per year. [15][16][17] This risk is further increased in the presence of concurrent HIV, which is annually estimated to be present in 6.6 per 1000 injection drug users; this number reflects a dramatic reduction since the advent of highly active anti-retroviral therapies. 18 Another rare complication of injection drug use is osteomyelitis, which should be considered in the appropriate clinical context.…”

Section: Discussionmentioning

confidence: 99%

Cotton Fever: Does the Patient Know Best?

2015

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Fever and leukocytosis have many possible etiologies in injection drug users. We present a case of a 22-year-old woman with fever and leukocytosis that were presumed secondary to cotton fever, a rarely recognized complication of injection drug use, after an extensive workup. Cotton fever is a benign, self-limited febrile syndrome characterized by fevers, leukocytosis, myalgias, nausea and vomiting, occurring in injection drug users who filter their drug suspensions through cotton balls. While this syndrome is commonly recognized amongst the injection drug user population, there is a paucity of data in the medical literature. We review the case presentation and available literature related to cotton fever. I njection drug use is associated with many infectious and non-infectious complications. The most common associated complications faced by managing physicians are soft-tissue infections, overdose, intoxication, and withdrawal.1 A frequent and challenging triage dilemma in this population is that of fever with active injection drug use. Despite numerous unsuccessful attempts to develop discriminating decision rules to guide ambulatory triage in these cases, clinicians are still unable to reliably exclude occult infections such as endocarditis and osteomyelitis. 2,3 This often results in short-term hospitalization of these patients, with accrual of health care expenditures. 4 An infrequently recognized cause of fever in injection drug users is cotton fever, a poorly characterized systemic febrile inflammatory syndrome seen in this population. Ironically, while there is a paucity of literature and awareness in the medical community, cotton fever is a wellrecognized syndrome amongst injection drug users. Originally coined in 1975, cotton fever was described as a benign selflimited febrile syndrome occurring in injection drug users who filtered their drug suspensions through cotton balls. 5 We present a case of presumed cotton fever in an active injection heroin user, in whom the diagnosis was only considered upon hearing the patient reference the syndrome after substantial workup had been completed. Additionally, a review of the medical literature and a discussion of the current theories about the pathophysiology of cotton fever are presented. CASE REPORTA 22-year-old woman presented to an outside hospital 4 hours after developing acute onset of fevers, headache, abdominal pain and radiating back pain, which began 20 minutes after injecting heroin. She did not endorse any visual symptoms, chest pain, dyspnea, or rashes. Initial vital signs were notable for a temperature of 39°C and heart rate of 102 beats per minute. At the time, the remainder of her exam was reported as normal except for diffuse abdominal tenderness. In the setting of acute back pain, a lumbar spine MRI was obtained and interpreted as consistent with an L3-S2 epidural abscess. Blood cultures were drawn, and the patient was started on vancomycin and ceftriaxone. Twelve hours after initiation of symptoms, the patient was transferred to our instituti...

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“…nfective endocarditis (IE) is a serious infection that was historically a disease of children and young adults with underlying chronic rheumatic heart disease (1) but today is additionally associated with prosthetic heart valves, injection drug use, and intravascular catheters (2). Accurate and prompt detection of the infecting organism(s) is essential to ensure appropriate management.…”

mentioning

confidence: 99%

PCR-Electrospray Ionization Mass Spectrometry for Direct Detection of Pathogens and Antimicrobial Resistance from Heart Valves in Patients with Infective Endocarditis

Brinkman¹,

Vergidis²,

Uhl³

et al. 2013

J Clin Microbiol

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dMicrobiological diagnosis is pivotal to the appropriate management and treatment of infective endocarditis. We evaluated PCRelectrospray ionization mass spectrometry (PCR/ESI-MS) for bacterial and candidal detection using 83 formalin-fixed paraffinembedded heart valves from subjects with endocarditis who had positive valve and/or blood cultures, 63 of whom had positive valvular Gram stains. PCR/ESI-MS yielded 55% positivity with concordant microbiology at the genus/species or organism group level (e.g., viridans group streptococci), 11% positivity with discordant microbiology, and 34% with no detection. PCR/ESI-MS detected all antimicrobial resistance encoded by mecA or vanA/B and identified a case of Tropheryma whipplei endocarditis not previously recognized.

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Prospective Study of Infective Endocarditis among Injection Drug Users

Cited by 132 publications

References 20 publications

2015 ESC Guidelines for the management of infective endocarditis

2015 ESC Guidelines for the management of infective endocarditis

Cotton Fever: Does the Patient Know Best?

PCR-Electrospray Ionization Mass Spectrometry for Direct Detection of Pathogens and Antimicrobial Resistance from Heart Valves in Patients with Infective Endocarditis

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