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Heroin-Associated Infective Endocarditis: A Report of 28 Cases

NEIL P. DREYER, M.D.; and BERNARD N. FIELDS, M.D.
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Grant support: training grant AI-T01 AI-00405-03, National Institutes of Health.

▸Requests for reprints should be addressed to Bernard N. Fields, M.D., Department of Medicine, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY 10461.


Bronx, New York


Ann Intern Med. 1973;78(5):699-702. doi:10.7326/0003-4819-78-5-699
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Twenty-eight cases of heroin-associated infective endocarditis treated in 2 years represents a striking increase in cases over prior years. Predominant right-sided valvular involvement was found in 28.5%. Staphylococci were isolated in 68% and streptococci in 14%. Only in one case each was Candida or a Gram-negative organism (Haemophilus) isolated. Fifty percent had neurologic manifestations; the incidence of other embolic and hypersensitivity phenomena was not different from that reported in nonheroin cases. Of note were three cases of purulent panophthalmitis, a complication infrequently reported. Of five deaths, four were caused by congestive heart failure. Comment is directed at the great variation in organisms and type of valvular involvement reported in the literature.

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