par Laurent, Marius ;Dratwa, Max
Référence Acta clinica Belgica (Ed. multilingue), 31, 3, page (144-152)
Publication Publié, 1976
Article révisé par les pairs
Résumé : Endocarditis with other infectious diseases is the most frequent complication of heroin addiction, second only to overdosing. A lethal case of staphylococcus aureus endocarditis in a heroin addict patient is reported. Findings included involvement of mitral and pulmonary valves, pericarditis, peripheral and pulmonary septic emboli, and renal failure. Pathologic examination demonstrated disseminated phagocytised talc particles. Perusal of previously reported cases pointed out several characteristics of heroin addict endocarditis. Tricuspidian staphylococcal endocarditis is the rule, whereas pulmonary valve involvement is exceptional. High bacterial activity is assumed to be the cause of the severe and rapid evolution, which is commonly observed. Heart murmurs are generally of poor diagnostic value. Most frequently associated complications include pulmonary emboli with secondary abscess, parenteral injection of talc or cotton particles, and serum hepatitis (HAA). An increased concentration of immunoglobulins (IgM) is frequently demonstrated. Renal complications in heroin addict patients (glomerulonephritis) are associated with antigen antibody deposits (unknown antigen) upon the glomerular basement membrane, as described in bacterial endocarditis and particularly in staphylococcal endocarditis.