title: Intravenous melatonin abuse leading to recurrent aortic valve endocarditis: a case report and discussion.
abstract: BACKGROUND
  Reports of inappropriate medication use are widespread. There is a growing literature detailing abuse of drugs not typically thought to have high abuse liability. Melatonin is considered to be generally safe and is categorized by the Food and Drug Administration as a nutritional supplement. There are no known reports of intravenous melatonin abuse in the medical literature.
  
  
  METHODS
  The authors report a case of a patient injecting melatonin with euphoric and then sedative effects leading to two episodes of infective endocarditis culminating in aortic valve replacement.
  
  
  CONCLUSIONS
  Infective endocarditis continues to be a major potential complication of intravenous drug abuse. The proliferation of novel street drugs, resurgence in the use of older drugs and ongoing abuse of medications warrant continued research and vigilance in treating substance use disorders and attendant medical complications.
authors.affiliation: Department of Psychiatry, University of Washington, Boise Veterans Administration Medical Center, 500 W. Fort St., Boise, ID, 83702, USA. mark.warren@va.gov.
authors.forename: Mark B
authors.initials: MB
authors.lastname: Warren
authors.affiliation: Department of Internal Medicine, University of Washington, Boise Veterans Administration Medical Center, 500 W. Fort St., Boise, ID, 83702, USA. jonathan.stabler@va.gov.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Stabler
authors.affiliation: Department of Internal Medicine, University of Washington, Boise Veterans Administration Medical Center, 500 W. Fort St., Boise, ID, 83702, USA. Melissa.hagman2@va.gov.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hagman
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000601:surgery*; D004697:Endocarditis, Bacterial / Q000209:etiology* / Q000601:surgery; D006350:Heart Valve Prosthesis; D006351:Heart Valves / Q000382:microbiology; D006801:Humans; D008297:Male; D008550:Melatonin / Q000008:administration & dosage / Q000009:adverse effects*; D015819:Substance Abuse, Intravenous / Q000150:complications*; D014481:United States
chemical_list: D008550:Melatonin