The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Favorable Experience with Bacterial Endocarditis in Heroin Addicts

[+] Article, Author, and Disclosure Information

Supported in part by grant 5 TOI A100208, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.

▸Requests for reprints should be addressed to Sherwood L. Gorbach, M.D., Veterans Administration Hospital, Sepulveda, Calif. 91343.

Chicago, Illinois

Ann Intern Med. 1973;78(1):25-32. doi:10.7326/0003-4819-78-1-25
Text Size: A A A

During a prospective 18-month study we saw 23 cases of bacterial endocarditis in heroin addicts. The infecting organisms were Staphylococcus aureus (16), Streptococcus faecalis (3), Strep. viridans (2), Pseudomonas (1), and mixed streptococci and Enterobacter (1). Solitary tricuspid involvement with Staph. aureus was seen in 11 patients; all had septic pulmonary emboli, but only 5 had splenomegaly, 5 had hematuria, and 1 had peripheral stigmata in the conjunctivas or nail beds. Of seven patients with left-sided endocarditis (mitral or aortic valve disease), all had hematuria, five had peripheral stigmata, and four had splenomegaly. Complications of endocarditis included aortic valve rupture, empyema, severe respiratory insufficiency, embolus to central nervous system with hemiparesis, gastrointestinal bleeding, septic joints, and renal failure. All patients survived, including three in whom the initial antibiotic failed and three who subsequently relapsed and required retreatment. Improved survival can be obtained with early diagnosis and intensive management of complications.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.