STAPHYLOCOCCUS-AUREUS ENDOCARDITIS IN DANISH INTRAVENOUS-DRUG-USERS -HIGH PROPORTION OF LEFT-SIDED ENDOCARDITIS

In a retrospective study covering the years 1982-1989 episodes of Stap hylococcus aureus endocarditis in 51 intravenous drug users were studi ed, Tricuspid involvement dominated (34/51), but the frequency of left -sided involvement (33.3%) was greater than in earlier reports, Involv ement of both sides of the heart was not detected, but 27.8% of the le ft-sided endocarditis cases had multiple pulmonary infiltrates, indica ting that some of them might have had a concomitant right-sided endoca rditis. The 2 groups were compared: patients with left-sided endocardi tis were significantly older and with a longer time of intravenous dru g use, The complication rate was the same (44.1%) as was the duration of antibiotic treatment (median 42 days), In total, five patients unde rwent surgery, two (5.8%) due to right-sided failure and three (29.4%) because of left-sided endocarditis, The mortality of tricuspid endoca rditis was low (2.9%), whereas 5 patients (29.4%) with left-sided invo lvement died. The patients who died were significantly older and had a shorter duration of symptoms before hospitalization.