Endocarditis in parenteral drug abusers. Right-sided endocarditis. Influence of HIV infection

Infective endocarditis is a life-threatening infective complication in parenteral drug abusers. The tricuspid valve is the structure most frequently affected and Staphylococcus aureus the predominant microorganism. Fever, multiple pulmonary emboli and sustained bacteremia by S. aureus are signs of clinical alert for right-sided endocarditis in these patients. Echocardiography has developed a significant improvement in diagnosis and the transthoracic mode has a considerable reliability when high suspicion is established. Outcome is usually favourable with mortality less than 10%. Recent studies have made shorter treatments possible in selected patients and oral therapy is also considered. HIV infection, in advanced status, may indicate a worse survival rate.