TIP OF THE ICEBERG; INFECTIVE ENDOCARDITIS IN AN INTRAVENOUS DRUG USER
Tricuspid valve infective endocarditis is a known complication of Injecting drug use (IVDU) and is said to be rare in Africa. The most common etiological microbial agent of infective endocarditis (IE) in IVDU is Methicillin sensitive Staphylococcus aureus. Antibiotic treatment should start immediately after blood cultures have been obtained once IE is diagnosed. Treatment of IE in patients with IVDU is more difficult, and has a high recurrence rate due to medical non-compliance and continuing IVDU. The status of IVDU in Ethiopia is not known. The updated strategies of diagnosis and treatment as well as prognosis of IE in an IVDU patient who presented with respiratory symptoms and later diagnosed with TV endocarditis will be discussed.
Keywords: Tricuspid valve endocarditis, Infective endocarditis, Right-sided Endocarditis, Injecting drug use
Mylonakis E, Calderwood SB. Infective endocarditis in adults. N Engl J Med. 2001; 345:1318-30.
Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J. 2009;30:2369-413 [PMID: 19713420 DOI: 10.1093/eurheartj/ehp285].
Bouza E, Menasalvas A, Munoz P, Vasallo FJ, del Mar Moreno M, MA. GaFn. Infective endocarditis: A prospectivestudy at the end of the twentieth century-new predisposingconditions, new etiologic agents and still a high mortality. Medicine (Baltimore) 2001;80:298 307.
UNODC. World Drug Report United Nations, New York2014.
Aceijas C, Friedman SR, Cooper HL, Wiessing L, Stimson GV, Hickman M. Estimates of Intravenous drug users at the national and local level in developing and transitional countries, and gender and age distribution. . Sex Transm Infect 2006;82:10-7.
Miro JM, del Rio A, Mestres CA. Infective endocarditis and cardiac surgery in intravenous drug abusers and HIV-1 infected patients. CardiolClin. 2003;21:167-84.
Cooper H, Brady J, Ciccarone D, Tempalski B, Gostnell K, Friedman SR. Nationwide increase in the number of hospitalizations for illicit injection drug use-related infective endocarditis. Clin Infect Dis. 2007;45:1200-3.
Brouqui P, Raoult D. Endocarditis due to rare and fastidious bacteria. Clin Microbiol Rev. 2001;14:177-207.
San Roman JA, Vilacosta I, Zamorano JL, Almerı´a C, Sa´ nchez-HarguindeyL. Transesophageal echocardiography in right-sidedendocarditis. J Am Coll Cardiol. 1993;21:1226-30.
Gottardi R, Bialy J, Devyatko E, Tschernich H, Czerny M, Wolner E, et al. Midterm follow-up of tricuspid valve reconstruction due to active infective endocarditis. Ann Thorac Surg. 2007;84:1943-8.