Infective Endocarditis & People Who Inject Drugs
There has been a three-fold increase in the cases of infective endocarditis among people who injected drugs (PWID) from 1999 to 2016. In 2016, 18.9% of deaths from infective endocarditis were related to PWID. The rise of infective endocarditis parallels the opioid epidemic and the increase of new infections of hepatitis C (HCV).
Infective endocarditis is a life-threatening disease that occurs when bacteria or fungi enter the bloodstream and attack the lining of the heart and heart valves. The infection can also affect other organs—the lungs, kidneys, and brains. The infection may occur as a result of a break in the skin caused by a medical or dental procedure, congenital heart disease, heart value damage, heart value implants, and from injection drug use.
The type of endocarditis that usually affects PWID is acute endocarditis caused by Staphylococcus (staph) that enters the bloodstream. The infection related to PWID is primarily from the re-use of needles and drug works (water, cotton, ties, cookers, etc.).
The symptoms of acute infective endocarditis include high fever, chest pain, shortness of breath, cough and extreme fatigue. Once the symptoms develop the infection can progress very quickly and the person should seek immediate medical care as soon as possible. The diagnosis is based on risk factors, symptoms, blood samples and echocardiography to look inside the heart for abnormalities and infection.
The treatment for a mild case of infective endocarditis is a six-week course of intravenous antibiotics. A serious infection may result in a surgical replacement of the heart valve. Recognizing the symptoms of infective endocarditis, and early treatment with antibiotics can result in a full recovery
To prevent infective endocarditis, the person should avoid sharing needles, works, and make sure to wipe the injection site with alcohol. Seek out your needle exchange for clean needles, works, and other services. Ask for more information on prevention of infective endocarditis, HIV, HCV, and other illnesses.
For more information about safety see our Harm Reduction Fact Sheet: http://hcvadvocate.org/hepatitis/factsheets_pdf/HarmReduction/Infective-Endocarditis.pdf
Increasing Infectious Endocarditis Admissions Among Young People Who Inject Drugs—A. G. Wurcel, et. al.