?? about endocarditis

[RxQueen]

here's something i've often wondered about, but always end up forgetting to ask while i'm here.

we all (or at least, a LOT of us) know that endocarditis is a risk associated with IV drug use. what i don't know is, is this something that can happen suddenly after a hit, or is it one of those things that can crop up long afterwards? in other words, if i haven't had any problems yet with my heart's lining and if i never shot up again, would that mean i'm in the clear? or could i be in danger of it for the rest of my life after being an IVDU?

don't worry... i'm not having any symptoms, or worrying myself sick about this or anything. it's just a matter of curiosity for me, and i thought that one of our health pros might be able to finally give me a solid answer about this.

[skc74]

I used to know a guy who lived on the streets that got bacterial endocarditis,and his symptoms started about 24 hours after the hit that caused it,-vomiting,sweating,chest pains,breathlessness,etc.,and by around the 48 hour mark,he was having a prosthetic heart valve put in,because the infection spread,i think the rapidness of the symptoms depend on what strain of bacteria,or virus is causing the condition,but when it came to any notions of harm reduction by ensuring at least basic hygenie,this guy didnt give a fuck,luckily,he survived and is now clean,and raising a family in portugal whree he was from.

[chopstix]

I know some, but I'm sure others here know more than me. TMK, it tends to happen quickly, and damage can happen quickly. It's more common with lower "level" users cos a lot has to do with being sanitary and shooting shit you shoudn't. Though it is a risk and something you should be aware of if you are an IV user.

I knew a junky couple in Seattle, University Village. Sick as fuck one day, tryin' to figure out what to do, they found a spoon full of chunky black shit, so they fixed it. One got an instant fever and one got instant endo. It was blood and spit that someone had left and nowhere near dope.

I can't specify details but it was ugly, one was immediately admitted and *I think* both survived, but it was bad.

Endo is no fucking joke.

[RxQueen]

well then, at least this should probably be one thing i won't need to worry about as long as i maintain my decent sanitary habits... rather than something that'll crop up 10 years down the road to bite my ass.

now i just need to go throw up everything i ever ate.... goddammit chop, that story is FOUL!! dried blood and spit.... *shudder*

:vomit2:

[bigfootlives]

I would like to add that there is infective endocarditis as described above and there is also marantic endocarditis. Marantic endocarditis is caused by sterile non-biological material depositing within the heart. This form of endocarditis may be caused from injectin pills that haven't been properly filtered. This is one of the reasons why we'd rather use wheel filters when shooting pills and is a reason for my recent rant in the harm reduction forum about not beign able to get them here in Canada. Anyways, marantic endocarditis typically doesn't cause problems on it's own, but poses a concern because portions of the sterile material may break off and embolize in the brain or heart causing a stroke or empysema. The sterile material within the heart may also serve as an area where bacteria may lodge, effectively causing bacterial endocarditis as described above.

[RxQueen]

interesting that you bring that up, bigfoot. i've always been told about the dangers of the shit from injecting pills depositing on the heart's valves, possibly damaging them or just providing that area for bacteria to lodge and grow. but does that cause infection on just the valve, or can that cause endocarditis on its own as well?

(i like learning stuff!)

[candy]

Endocarditis associated with intravenous drug use

This condition most commonly involves the tricuspid valve, followed by the aortic valve.
Two thirds of patients have no previous history of heart disease and no murmur on admission. A murmur may not be heard in patients with tricuspid disease because of the relatively small pressure gradient across this valve. Pulmonary manifestations may be prominent in patients with tricuspid infection: one third have pleuritic chest pain, and three quarters demonstrate chest radiographic abnormalities.
Diagnosis of endocarditis in intravenous drug users can be difficult and requires a high index of suspicion.
S aureus is the most common (<50% of cases) etiologic organism. Other causative organisms include streptococci, fungi, and gram-negative rods (eg, pseudomonads, Serratia species). Methicillin-resistant S aureus (MRSA) accounts for an increasing portion of S aureus infections and has been associated with previous hospitalizations, long-term addiction, and nonprescribed antibiotic use.Endocarditis in intravenous drug abusers commonly involves the tricuspid valve.
S aureus is the most common causative organism.Infections, in particular soft tissue infections (cellulitis, skin abscesses), are the leading cause for emergency department visits and hospital admissions of drug injection users (IDUs).Staphylococcus aureus is the most relevant bacterial pathogen in this population. It is the main cause of soft tissue infections and of severe infections such as endocarditis and bacteremia. Moreover, epidemic spread of methicillin-resistant S. aureus (MRSA) among IDUs has occurred in Europe and North America. Nasal carriage of S. aureus is associated with an increased risk of subsequent S. aureus infections, and it has been shown that active IDUs have a higher rate of colonization with S. aureus than the general population. However, it is still unknown why an individual carries S. aureus. In particular, repeated injections do not appear to be the main predisposing factor for S. aureus carriage.

Infections associated with injection drug use are frequently the consequence of the illegal status of street drugs. Harm reduction programs, including needle exchange programs, safer injecting facilities and injection opiate substitution programs can reduce the incidence of infections among severely addicted IDUs.


Just some info I found on the internet. I have not been feeling well so I just took some info I had on the internet.
I hope it helps to understand it a bit more.

But, washing your hands and using alcohol to clean the skin is a good way to help prevent any infection
and don't for get to keep the equipment you use clean as well for prepping a shot.

Be safe.

[RxQueen]

thanks candy! those items were about acute infection (as in, immediately after a shot), i'm assuming. or can all that happen weeks/months/years after the fact?

PS... hope you're feeling better soon!

[roxi*stardust]

There is infective and non-infective Endocarditis. Like bigfoot mentioned, non-infective Endocaritis is caused by injecting improperly or unfiltered pills. This is caused by the build of of non-soluble binders like talc building up either directly in the heart valves or in the lung and breaking off and traveling to the heart valves and causing irritation and inflammation of the tissues of the heart and heart valves.
Infective Endocarditis is caused by bateria. In IV drug users Endocarditis most of occurs on the right side of the heart, affecting th Tricuspid Valve and is caused by S. Aureus, a common type of Staph bacteria. In fact this is the same bacteria known to most often causes abcesses in IV drug users. This is why it is so important to practice proper injection techniques. The reason right-sided Endocarditis is most often seen in IV drug users is because the veins used to inject travel to the right side of the heart.

[candy]

Thank you for adding that information Roxi and RxQueen......I am in some kind of brain fog
lately and have been dealing with some real crazy physical problems!
I will know in a day or two what is wrong with me!

THANK YOU for being so well informed!

[Poppylvr]

Using only drugs meant for IV use or filtering the hell out of whatever you inject will help reduce the risk of infective endocarditis. I lucked out depsite 1.5 yeats of many times a day IV use because I had pharmacuetical morphine & sterile syringes for each injection.
RxQuen, I don't thnk that past use puts you at risk; I believe it's more related to acute use with not very well filtered drugs, or using tap water or worse to dilute. If I get time at the hospital tonight, I'll research some more.
CANDY - I hope you feel better soon - you can let me know in semi private what's going on, if you don't want to share with the whole world that you have herpesyphylgonorAIDS......

[edhorfin]

I was admitted to the hospital once in the 80's with a fever of unknown origin. After many tests, I finally copped to IVDU, and the docs immediately suspected bacterial endo. A sonogram of my heart revealed no vegetations, (their terms). After developing serum sickness as an allergic response to sulfa drugs, (another story in itself), they finally dicontinued all meds to see what would develop. The fever went away and I got better.

In retrospect, it was almost certainly the acute phase of HepC, which they didn't have a test for. Not sure if my liver numbers were high, I can go back and look.(I had them copy my chart, which REALLY pissed them off)

Anyway, endo can take a long time to develop, or not. I think cardiac sonogram is still the test protocol, but not sure. The treatment used to be IV antibiotics, vancomcin and/or tobramycin. Both fairly nasty drugs, kidney wise, but very potent mothers....

Ed

[chopstix]

The reason right-sided Endocarditis is most often seen in IV drug users is because the veins used to inject travel to the right side of the heart.

FWIW, I used to use my jugular almost exclusively - it's *huge*, but unfortunately succumbed to the tar and receeded and hardened and doesn't work anymore, but I used it for years and years.

I had a doctor tell me once that it was a bad idea to fix there cos it's so close to the heart and increased the risk of endo...