Abstract
In recent years, the drug abuse among young people has become a serious social problem. In drug abuse, intravenous drug user (IDU) is high risk population of infective endocarditis (IE). Many cases of IE happened after surgical intervention like dental procedures in the patients with cardiac valvular or congenital heart disease. However, in the IDU, IE could happen even in normal valves. Intravenous drug use must be considered in young patients who show the sign of IE. We report a case of IE that occurred in an IDU. A 20-year-old female with a history of intravenous drug abuse was transferred to our department with generalized pain and restlessness. Vegetation on the mitral valve was detected by cardiac ultrasonography, and methicillin-sensitive Staphylococcus aureus was positive on blood culture. In addition, cerebral infarctions associated with micro-bleedings were also found on MRI. We diagnosed IE due to intravenous drug abuse, and antibiotic administration was started. However, 14 days after admission, she developed decompensated heart failure due to advanced mitral regurgitation (MR), resulting in the endotracheal intubation and placed on ventilator assistance. Then, mitral valve replacement (bioprosthesis) and tricuspid valvuloplasty were performed 17 days after admission. The patient’s postoperative course was uneventful, and she discharged on postoperative day 49. The patient currently remains under regular follow-up by both the departments of cardiovascular surgery and psychiatry 6 months after surgery, and the recurrence of IE is not observed.
