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. 1976 Apr;124(4):276–281.

Neurological Complications of Endocarditis in Persons Taking Drugs Intravenously

Harry Openshaw 1,2,3
PMCID: PMC1130040  PMID: 1266214

Abstract

A study was made of 46 cases of endocarditis in persons known to take drugs intravenously. Findings included significantly lower ages for those patients in whom infections were right-sided. The neurological complication rate was 39 percent overall and 58 percent in the left-sided group. Neurological complications are unusual in right-sided infection. In about a third of those with neurological complications there were sensorial changes without focal signs. Despite a high mortality, neurological complications in Group D streptococcal endocarditis were relatively infrequent. One case is presented in which a foreign body may have contributed to the formation of the embolic material. The clinical and neuropathological features encountered are compared with those reported in persons with endocarditis who were not addicts. The review indicates that neurological complications in nonaddicts and in addicts are similar in type but are more common and severe in addicts.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Banks T., Fletcher R., Ali N. Infective endocarditis in heroin addicts. Am J Med. 1973 Oct;55(3):444–451. doi: 10.1016/0002-9343(73)90201-5. [DOI] [PubMed] [Google Scholar]
  2. Cherubin C. E., Baden M., Kavaler F., Lerner S., Cline W. Infective endocarditis in narcotic addicts. Ann Intern Med. 1968 Dec;69(6):1091–1098. doi: 10.7326/0003-4819-69-6-1091. [DOI] [PubMed] [Google Scholar]
  3. Davis J. M., Moss A. J., Schenk E. A. Tricuspid candida endocarditis complicating a permanently implanted transvenous pacemaker. Am Heart J. 1969 Jun;77(6):818–821. doi: 10.1016/0002-8703(69)90418-9. [DOI] [PubMed] [Google Scholar]
  4. Detmer D. E., Morrow A. G., Marsh H. H., 3rd, Braunwald N. S. Experimental endocarditis following cardiac valve replacement. Evaluation of cloth-covered valves and the role of antibiotics. J Thorac Cardiovasc Surg. 1970 Jul;60(1):46–50. [PubMed] [Google Scholar]
  5. Dreyer N. P., Fields B. N. Heroin-associated infective endocarditis. A report of 28 cases. Ann Intern Med. 1973 May;78(5):699–702. doi: 10.7326/0003-4819-78-5-699. [DOI] [PubMed] [Google Scholar]
  6. Gilroy J., Andaya L., Thomas V. J. Intracranial mycotic aneurysms and subacute bacterial endocarditis in heroin addiction. Neurology. 1973 Nov;23(11):1193–1198. doi: 10.1212/wnl.23.11.1193. [DOI] [PubMed] [Google Scholar]
  7. Greenlee J. E., Mandell G. L. Neurological manifestations of infective endocarditis: a review. Stroke. 1973 Nov-Dec;4(6):958–963. doi: 10.1161/01.str.4.6.958. [DOI] [PubMed] [Google Scholar]
  8. Jones H. R., Jr, Siekert R. G., Geraci J. E. Neurologic manifestations of bacterial endocarditis. Ann Intern Med. 1969 Jul;71(1):21–28. doi: 10.7326/0003-4819-71-1-21. [DOI] [PubMed] [Google Scholar]
  9. Katz R. I., Goldberg H. I., Selzer M. E. Mycotic aneurysm. Case report with novel sequential angiographic findings. Arch Intern Med. 1974 Nov;134(5):939–942. doi: 10.1001/archinte.134.5.939. [DOI] [PubMed] [Google Scholar]
  10. Lerner A. M., Oerther F. J. Characteristics and sequelae of paregoric abuse. Ann Intern Med. 1966 Nov;65(5):1019–1030. doi: 10.7326/0003-4819-65-5-1019. [DOI] [PubMed] [Google Scholar]
  11. Louria D. B., Hensle T., Rose J. The major medical complications of heroin addiction. Ann Intern Med. 1967 Jul;67(1):1–22. doi: 10.7326/0003-4819-67-1-1. [DOI] [PubMed] [Google Scholar]
  12. Menda K. B., Gorbach S. L. Favorable experience with bacterial endocarditis in heroin addicts. Ann Intern Med. 1973 Jan;78(1):25–32. doi: 10.7326/0003-4819-78-1-25. [DOI] [PubMed] [Google Scholar]
  13. Min K. W., Gyorkey F., Cain G. D. Talc granulomata in liver disease in narcotic addicts. Arch Pathol. 1974 Nov;98(5):331–335. [PubMed] [Google Scholar]
  14. Molinari G. F., Smith L., Goldstein M. N., Satran R. Pathogenesis of cerebral mycotic aneurysms. Neurology. 1973 Apr;23(4):325–332. doi: 10.1212/wnl.23.4.325. [DOI] [PubMed] [Google Scholar]
  15. Ramsey R. G., Gunnar R. M., Tobin J. R., Jr Endocarditis in the drug addict. Am J Cardiol. 1970 May;25(5):608–618. doi: 10.1016/0002-9149(70)90600-4. [DOI] [PubMed] [Google Scholar]
  16. Sapira J. D. The narcotic addict as a medical patient. Am J Med. 1968 Oct;45(4):555–588. doi: 10.1016/0002-9343(68)90172-1. [DOI] [PubMed] [Google Scholar]
  17. Silver W., DeGuzman A., Joos H. A., Garzon A. A. Intracardiac catheter as a foreign body of six years' duration resulting in endocarditis. Chest. 1971 Mar;59(3):344–346. doi: 10.1378/chest.59.3.344. [DOI] [PubMed] [Google Scholar]
  18. Wellmann K. F., Reinhard A., Salazar E. P. Polyethylene catheter embolism. Review of the literature and report of a case with associated fatal tricuspid and systemic candidiasis. Circulation. 1968 Mar;37(3):380–392. doi: 10.1161/01.cir.37.3.380. [DOI] [PubMed] [Google Scholar]
  19. Zientara M., Moore S. Fatal talc embolism in a drug addict. Hum Pathol. 1970 Jun;1(2):324–327. doi: 10.1016/s0046-8177(70)80046-6. [DOI] [PubMed] [Google Scholar]
  20. Ziment I. Nervous system complications in bacterial endocarditis. Am J Med. 1969 Oct;47(4):593–607. doi: 10.1016/0002-9343(69)90189-2. [DOI] [PubMed] [Google Scholar]

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