title: Infective endocarditis in an HIV-infected intravenous drug user.
abstract: Infective endocarditis is a common complication among injecting drug users. Disease risk among these patients is increased by the spread of HIV infection. In the following article, we discuss the exceptional clinical presentation of a 28-year-old patient who used intravenous drugs (heroin) for 10 years, had been infected with HIV for seven years and as a complication had developed Staphylococcus aureus infective endocarditis. The patient came to the hospital in serious condition, complaining of bodily pain, swelling of the legs and general weakness. During hospitalization, besides infective endocarditis, she was also diagnosed with anemia, toxic hepatitis, renal failure, ascites, sepsis, and pneumonia. A completely disrupted tricuspid valve, damaged aortic valve, and fibrosis of the mitral valve were detected. Echocardiographic and radiologic data showed that the patient's condition continued to deteriorate day by day, with significant progression of heart failure, ejection fraction decreasing from 45% to 10%, and development of myocarditis, hydrothorax and pericarditis. However, this progressive worsening of the patient's condition ceased when vancomycin was administered. To the authors' knowledge, this is the first such case described in the literature in which significant improvement was observed despite the patient's complex condition with associated complications.
authors.affiliation: Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania.
authors.forename: Karolina
authors.initials: K
authors.lastname: Mėlinytė
authors.affiliation: Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania.
authors.forename: Jurgita
authors.initials: J
authors.lastname: Savickaitė
authors.affiliation: Clinic of Internal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania. Electronic address: daiva.rekiene@gmail.com.
authors.forename: Daiva Emilija
authors.initials: DE
authors.lastname: Rekienė
authors.affiliation: Clinic of Internal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Albinas
authors.initials: A
authors.lastname: Naudžiūnas
authors.affiliation: Institute of Anatomy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Aušra
authors.initials: A
authors.lastname: Burkauskienė
authors.affiliation: Clinic of Internal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Laima
authors.initials: L
authors.lastname: Jankauskienė
mesh_terms: D000328:Adult; D004697:Endocarditis, Bacterial / Q000209:etiology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D013203:Staphylococcal Infections / Q000209:etiology*; D015819:Substance Abuse, Intravenous / Q000150:complications*
keywords: Endocardite infecciosa; HIV; Infective endocarditis; Intravenous drug use; Tricuspid valve; Utilização de fármaco intravenoso; VIH; Válvula tricúspide