title: Pseudomonas maltophilia causing heroin-associated infective endocarditis.
abstract: The association of Pseudomonas maltophilia endocarditis in three patients with recent history of intravenous drug abuse is reported. All three patients had abnormal heart valves (two prosthetic and one rheumatic). A prominent characteristic of this uncommon pathogen is its in vitro resistance to the commonly used antimicrobials. Cure was achieved in all three cases. In two cases, synergistic antibiotic combinations were used. In one case, plasmid-mediated resistance to amikacin sulfate (Amikan, British; no comparable US product) emerged during therapy. The two patients with prosthetic valves received combined surgical and antibiotic therapy.
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D004357:Drug Synergism; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D005260:Female; D006350:Heart Valve Prosthesis; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011549:Pseudomonas / Q000187:drug effects; D011552:Pseudomonas Infections / Q000188:drug therapy; D013420:Sulfamethoxazole / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014295:Trimethoprim; D013420:Sulfamethoxazole