Infective endocarditis in intravenous drug users: Does HIV status alter the presenting temperature and white blood cell count?

The intent of this study was to determine if HIV seropositivity alters the maximum temperature (T-max) and WBC count of febrile intravenous (i.v.) dru g users with infective endocarditis (IE), A review of 497 charts of patient s with endocarditis provided 228 eligible patient visits (46%), with 158 ca ses (69.3 %) of IE among 126 patients (74 HIV+ and 52 HIV-), Mean T-max for all patients with IE was 39.1 degrees C (102.4 degrees F), Mean T-max was similar between the HIV+ (39.1 degrees C, 102.4 degrees F) and HIV- (39.2 d egrees C, 102.5 degrees F) groups. There were no differences in mean T-max among HIV+ patients with CD4 counts > 200 (39.0 degrees C, 102.3 degrees F) , those with CD4 less than or equal to 200 (39.2 degrees C, 102.5 degrees F ), and the HIV-group (39.2 degrees C, 102.5 degrees F), Nearly 8% of i.v. d rug users with confirmed IE presented to the ED with a T-max below 37.8 deg rees C (100.0 degrees F). Mean WBC count was significantly lower in HIV+ (1 1.1 k/mm(3)) than in HIV- patients (15.4 k/mm(3)) and significantly lower i n the group with CD4 less than or equal to 200 (8.0 k/mm(3)) than in the HI V- group. In conclusion, HIV infection was not associated with lower T-max, but it was associated with decreased WBC count in the general HIV+ group a nd in the group with CD4 less than or equal to 200. (C) 2000 Elsevier Scien ce Inc.