Infective endocarditis in intravenous drug users, evaluation of clinical and para-clinical presentation

Introduction: 60 percent of hospitalization causes of intravenous drug users are infection, of which 5 to 15 percent of them due to endocorditis. Infective endocorditis is a common infection among intravenous drug users and can cause high mortality and morbidity. This study was conducted to evaluate clinical and para-clinical presentations of drug users. Methods: In a descriptive study we evaluate 33 narcotic addicts with documented infective endocarditis in two tertiary care hospitals in Tehran, Iran Imam Hosein and Loghman Hakim hospitals during 2002-2008. Demographic information, clinical manifestation, radiologic, laboratory and echocardiographic data were evaluated. The data were analysed using SPSS software. Results: 82% of patients were in 20-40 year old age group. 52% of the cases were referred to the hospital with main complain of fever and cough and 27% with pain and fever. Fever was observed in 91% of the patients. Positive blood culture was observed in 9 cases and negative blood culture in 14 cases. The most common involved valve was tricuspid. Mortality rate was 45%. Conclusion: Endocarditis should be considered in intravenous drug users when they present with fever. Blood culture may be negative due to previous use of antibiotics and poor technique of culture.