Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- 84 Evaluation of suspected immunodeficiency
- 85 Infections in the neutropenic patient
- 86 Infections in patients with neoplastic disease
- 87 Corticosteroids, cytotoxic agents, and infection
- 88 Biologics
- 89 Infections in transplant recipients
- 90 Diabetes and infection
- 91 Infectious complications in the injection and non-injection drug user
- 92 Infections in the alcoholic
- 93 Infections in the elderly
- 94 Neonatal infection
- 95 Pregnancy and the puerperium: infectious risks
- 96 Dialysis-related infection
- 97 Overwhelming postsplenectomy infection
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
91 - Infectious complications in the injection and non-injection drug user
from Part XI - The susceptible host
Published online by Cambridge University Press: 05 April 2015
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- 84 Evaluation of suspected immunodeficiency
- 85 Infections in the neutropenic patient
- 86 Infections in patients with neoplastic disease
- 87 Corticosteroids, cytotoxic agents, and infection
- 88 Biologics
- 89 Infections in transplant recipients
- 90 Diabetes and infection
- 91 Infectious complications in the injection and non-injection drug user
- 92 Infections in the alcoholic
- 93 Infections in the elderly
- 94 Neonatal infection
- 95 Pregnancy and the puerperium: infectious risks
- 96 Dialysis-related infection
- 97 Overwhelming postsplenectomy infection
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
Summary
Drug abuse is a widespread public health problem because many of its medical complications are infectious due to the transmission of bloodborne, environmental, and respiratory infectious agents. Availability of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV)-infected substance abusers has reduced the severity and frequency of opportunistic infections seen in the intravenous drug users (IVDUs) and other drug users (DUs). That said DUs/IDUs remain the groups least likely to access care and to maintain adherence for optimal benefit. Recent studies find social and access factors related to criminalization are major barriers to care including HAART for these individuals. Increasing treatment options and societal acceptance of harm reduction efforts have been demonstrated to improve outcomes in countries that have undertaken them.
Endocarditis
Endocarditis, a life-threatening infection of the heart valves and/or endocardium, is associated with septic parenteral injections. Right-sided valvular infections are very frequent in IDUs because of septic inoculations. Intravenous injection with low-pressure venous return increases the susceptibility of right-sided valvular and other structures to infection. Concurrent pulmonary hypertension from drug adulterants, such as talc, may also predispose to right-sided disease.
Despite the high prevalence of endocarditis, the offending pathogens are not specific to injectors. Staphylococcus aureus, often methicillin-resistant S. aureus (MRSA), is the most commonly identified organism, but other pathogens are seen. These include Pseudomonas, Serratia, enterococci, Streptococcus groups A and B, and Streptococcus viridans. Increasingly, fungal pathogens are seen with and without immunodeficiency.
- Type
- Chapter
- Information
- Clinical Infectious Disease , pp. 591 - 596Publisher: Cambridge University PressPrint publication year: 2015