Staphylococcal endocarditis in addicts.
We retrospectively reviewed 55 episodes that fulfilled criteria for Staphylococcus aureus endocarditis in 50 drug addicts. The most common presenting symptoms were fever(90%), chest pain(58%), and cough(43%). All patients had evidence of right-sided heart involvement, and a murmur of tricuspid insufficiency was noted in 42%. Evidence of left-sided heart involvement was present in only 5%. The most helpful laboratory aid in facilitating an early clinical diagnosis of endocarditis was the chest x-ray film. Roentgenographic evidence of septic pulmonary emboli was present in 67% of initial chest films and eventually in 87% of all cases. All but five patients completed at least four weeks of intravenous antibiotic therapy. No patients required cardiac surgery and there were no deaths. The apparent predilection of S aureus for the right side of the heart and infrequent left-sided involvement may explain why addicts with endocarditis have a favorable response to antibiotic therapy.
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D007839:Functional Laterality; D006337:Heart Murmurs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis; D019966:Substance-Related Disorders / Q000150:complications*; D014262:Tricuspid Valve Insufficiency / Q000209:etiology
D000900:Anti-Bacterial Agents