Damar İçi Madde Bağımlısı Hastalarda Akla Gelmesi Gereken Bir Olasılık; İnfektif Endokardit/Considering The Possibility of Infective Endocartidis in Intravenous Drug Addicted Patiens

Infective endocarditis is an infection of cardiac valves and / or wall endocardium by pathogenic microorganisms. It remains important due to high morbidity-mortality. Non-specificity of findings, variable clinical picture and accompanying comorbidities may cause difficulties in diagnosis. In a study, it was shown that the diagnosis could not be made until autopsy in the majority of IE cases (27-38%), this rate did not change despite the advancement in diagnostic tools over the years and it was overlooked especially in patients with transplantation, and within the intensive care units. In this study, we drew attention to rare but possible pathology known as “infective endocarditis” based on two patients with intravenous substance use (ISU) who referred to our ICU with different pre-diagnoses (drug intoxication, pneumonia). As a result, ISU forms a high risk group for the development of infective endocarditis. Parallel to the increase in drug use in Western societies, the rate of ISU-related endocarditis seen in young adults (15-34 years old) has increased continuously from 27.7% to 42%. 12.1% of the endocarditis detected in North America in 2013 is due to ISU. The treatment costs of these patients are high because the rates of addiction relief after treatment are very low (<8%) and the readmission rates are very high (50%). In addition to this, this group of patients also creates additional social costs. In our country, although there is no clear information about the frequency of IE associated with ISU, infective endocarditis is a possibility that should be remembered and specifically investigated in young age patients who have a history of intravenous substance use in ICU and whose infection findings prevail.