scholarly journals Hemothorax due to Ruptured Mycotic Aneurysm of Intercostal Arteries Associated with Infective Endocarditis

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Eddie Y. Liu ◽  
Jennifer Crawford ◽  
Haissam Haddad
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Drug Use ◽  
Mycotic Aneurysm ◽  
Rare Complication ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Methicillin Resistant

We present a case of hemothorax due to ruptured mycotic aneurysm in three intercostal arteries in a 40-year-old male with methicillin-resistant Staphylococcus aureus infective endocarditis (IE) due to intravenous drug use. Microcoil embolization and thoracotomy successfully achieved hemostasis. Mycotic aneurysm is a rare complication of IE and is usually found in the intracranial vessels. Ruptured mycotic aneurysm in the intercostal arteries can be associated with IE and can present as acute hemothorax.

The Lived Experience of Nurses Caring for Patients Diagnosed With Intravenous Drug Use–Associated Infective Endocarditis in Appalachia: A Phenomenological Study

2021 ◽  
pp. 107839032110377
Author(s):  
Kendrea L. Todt ◽  
Sandra P. Thomas
Keyword(s):  
Substance Use ◽  
Infective Endocarditis ◽  
Drug Use ◽  
Substance Use Disorder ◽  
Phenomenological Study ◽  
Care Delivery ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Central Theme ◽  
Number Of Patients

BACKGROUND: The number of patients admitted with infective endocarditis (IE) from intravenous drug use (IVDU) in Appalachia is increasing, a direct downstream effect of the opioid crisis. Extant literature highlights the pejorative attitudes health care workers have toward patients with substance use disorder, with nurses among the most punitive. Rather than describe attitudes, the purpose of this study was to describe the lived experiences of nurses caring for patients diagnosed with IE from IVDU in Appalachia. OBJECTIVE: To describe an unexplored phenomenon in Appalachia to inform nursing practice, nursing education, and health policy. METHOD: Qualitative phenomenological study using the University of Tennessee method based on the tenets of Maurice Merleau-Ponty. Nine nurses (ages 29-53 years) recruited using purposive and snowball sampling participated in unstructured phenomenological interviews. RESULTS: The essential meaning or central theme of the nurse experience working with these patients was a sense of hopelessness/hope, with four interrelated themes derived from the central theme: (1) guarding/escaping, (2) responsibility and revulsion, (3) apathy/empathy, and (4) grief and sorrow/cold and unemotional. Universally, nurses perceived caring for this population as futile, feeling a sense of powerlessness to change the outcome. CONCLUSIONS: These care experiences frustrated nurses, who described being physically and emotionally drained. To improve care delivery and improve patient outcomes, emphasis must be placed on nurse addiction education and standardizing nurse to patient with substance use disorder ratios to decrease work-related stress on nurses.

Drug use-related right-sided infective endocarditis complicated by empyema and bronchopleural fistula

2022 ◽  
Vol 15 (1) ◽  
pp. e246663
Author(s):  
Lindsey M Shain ◽  
Taha Ahmed ◽  
Michele L Bodine ◽  
Jennifer G Bauman
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Bronchopleural Fistula ◽  
Disease Process ◽  
Intravenous Drug ◽  
Pulmonary Emboli ◽  
Intravenous Drug Use ◽  
Respiratory Complications

Right-sided infective endocarditis is frequently accompanied by septic pulmonary emboli, which may result in a spectrum of respiratory complications. We present the case of a 25-year-old woman diagnosed with infective endocarditis secondary to intravenous drug use. During a long and arduous hospital course, the patient developed empyema with bronchopleural fistula, representing severe but uncommon sequelae that may arise from this disease process. She was treated with several weeks of antibiotics as well as surgical thorascopic decortication and parietal pleurectomy.

scholarly journals 75 Infective endocarditis and intravenous drug use: a descriptive study

2018 ◽  
Author(s):  
Sam Straw ◽  
Wazir Baig ◽  
Richard Gillott ◽  
Francesco Pirone ◽  
Jonathan Sandoe
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Descriptive Study ◽  
Intravenous Drug ◽  
Intravenous Drug Use

scholarly journals 393. Changing Trends, Risk Factors, and Treatment Challenges in Staphylococcus aureus Septic Arthritis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S202-S202
Author(s):  
Valerie Gobao ◽  
Mostafa Alfishawy ◽  
Neel Shah ◽  
Karin Byers ◽  
Mohamed Yassin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Drug Use ◽  
Positive Result ◽  
Septic Arthritis ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Retrospective Case ◽  
Factors Associated ◽  
Rule Out

Abstract Background Staphylococcus aureus is a common organism in native septic arthritis. It is traditionally believed to be self-limited with rapid and aggressive debridement and appropriate antibiotic selection. The incidence of S. aureus septic arthritis is increasing, and further characterization is needed to improve diagnosis and treatment. For patients presenting with native S. aureus septic arthritis, we evaluated the reliability of methicillin-resistant S. aureus (MRSA) screening as a predictor to rule out MRSA septic arthritis, the risk factors associated with this disease, and the treatment and surgical outcomes. Methods A retrospective case–control study of patients diagnosed with septic arthritis in the UPMC health system (Pittsburgh, PA) between 2012 and 2016 was completed. The primary outcomes of interest were surgical intervention and the need to alter antibiotic treatment. Patient demographics, characteristics, and outcomes were recorded. Results A total of 215 cases of septic arthritis were identified, and 64% (n = 138) had S. aureus cultured. In this set, 36% (50/138) of these patients were identified with MRSA. Of the patients diagnosed with MRSA septic arthritis, 50% screened prior to admission had a positive result (8/16) and 48% screened during admission had a positive result (14/29). Compared with septic arthritis with other organisms, risk factors associated with S. aureus included history of intravenous drug use (OR: 4.3, CI: 1.7 to 10.8, P = 0.002) and being immunocompetent (OR: 0.3, CI: 0.1 to 0.6, P = 0.002). These infections were associated with concurrent infections of the spine (OR: 5.7, CI: 2.1 to 15.1, P = 0.0005). As compared with other organisms, there was a high probability of switching antibiotics during treatment (OR: 3.7, CI: 1.1 to 13.0, P = 0.04) and relapse of infection (OR: 4.2, CI: 1.2 to 14.6, P = 0.02). Conclusion S. aureus septic arthritis is associated with intravenous drug use, and not with immunosuppression. A negative MRSA screen does not rule out this organism. Concurrent spine infections are common. There is a high likelihood of infection relapse and that antibiotics will need to be altered during treatment. With the opioid epidemic, the incidence is likely to increase further. More work is needed to improve diagnosis and overcome treatment challenges. Disclosures All authors: No reported disclosures.

scholarly journals A Case ofSerratia marcescensEndocarditis in a Nonintravenous Drug-Using Male Patient and Review of Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Achilleas Nikolakopoulos ◽  
Nikolaos Koutsogiannis ◽  
Panagiota Xaplanteri ◽  
Charalambos Gogos ◽  
Fevronia Kolonitsiou ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Serratia Marcescens ◽  
Male Patient ◽  
Intravenous Drug ◽  
Medical Procedure ◽  
Intravenous Drug Use ◽  
Chordae Tendineae ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

Introduction.Serratia marcescensis a rare cause of infective endocarditis and has almost exclusively been associated with intravenous drug use and hospital-acquired infections. Here, we present a case of infective endocarditis caused bySerratia marcescensin an otherwise healthy, nonintravenous drug-using male patient.Case Report. A 41-year-old man presented with hypertension and hemoptysis. Blood cultures were obtained that showed bacteremia bySerratia marcescens. An echocardiogram was carried out that revealed severe mitral regurgitation accompanying ruptured mitral chordae tendineae. The patient received the appropriate antibiotic treatment, without further surgical intervention.Discussion.Hospital-acquired infections bySerratiaspecies are a common problem in medical practice and have been attributed to specialized interventional procedures. Taking into consideration the patient’s immunocompetence and lack of intravenous drug use, it is possible that bacteremia could be attributed to a medical procedure. Moreover, in contrast to most cases described in the literature, no surgery was performed.

Community-Acquired Methicillin-Resistant Staphylococcus Aureus Infections in Otolaryngology

1992 ◽  
Vol 107 (3) ◽  
pp. 434-437 ◽  
Author(s):  
Ron D. Gottlieb ◽  
Mahendra K. Shah ◽  
David C. Perlman ◽  
Charles P. Kimmelman
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Therapy ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Methicillin Resistant ◽  
Mrsa Strains ◽  
Hospital Acquired ◽  
Susceptibility And Resistance ◽  
Multiple Antibiotics

Soon after the introduction of methicillin, strains of Staphylococcus aureus resistant to methicillin were reported. Methicillin-resistant Staphylococcus aureus (MRSA) has become a common hospital pathogen, often resistant to multiple antibiotics, while causing significant morbidity and mortality. Community-acquired MRSA infections have been infrequently documented. Most reports have been associated with intravenous drug abuse. This report reviews 15 patients with community-acquired MRSA infections of the head and neck. None admitted to intravenous drug use. Additionally, no patient was known to be a healthcare worker. The MRSA strains showed antibiotic susceptibility and resistance profiles different from typical hospital-acquired MRSA isolates. All but one infection resolved with adequate surgical or appropriate antibiotic therapy. Clinicians should become aware of the possibility of community-acquired MRSA in the patient who has had continued infection despite antibiotic therapy.

scholarly journals Septic Pulmonary Embolism Causing Recurrent Pneumothorax in an Intravenous Drug User without Right-Sided Valvular Vegetation in Infective Endocarditis

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Mason Montano ◽  
Kevin Lee ◽  
Kushal Patel ◽  
Mutsumi Kioka
Keyword(s):  
Pulmonary Embolism ◽  
Infective Endocarditis ◽  
Pulmonary Valve ◽  
Rare Complication ◽  
Intravenous Drug User ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Indwelling Catheters ◽  
Septic Pulmonary Embolism ◽  
Valve Lesions

The following report illustrates a case of a 36-year-old Caucasian male with intravenous drug use (IVDU) induced septic thrombophlebitis presenting with recurrent unilateral pneumothoraces from septic pulmonary embolism (SPE) without the presence of obvious right-sided valvular vegetation in infective endocarditis (IE), defined as tricuspid or pulmonary valve lesions. Pneumothorax (PTX) has been observed as a rare complication of SPE and is commonly associated with infective right-sided IE, IVDU, and intravascular indwelling catheters. However, this case is novel as it is the very rare documented case of recurrent, unilateral, spontaneous right PTX refractory to multiple chest tube placements in such a setting. Therefore, the absence of detectable right-sided valvular vegetation in IE does not obviate the risk of SPE-induced PTX in IVDU and further expands the realm of infectious and pulmonary consequences of SPE and IVDU.

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