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The risk for infective endocarditis (IE) is markedly increased among injection-drug users (IDUs). Most cases in this population are caused by Staphylococcus aureus and involve the right side of the heart.
To document the epidemiology of IE among IDUs and to examine whether particular drugs might predispose users to right-sided endocarditis, investigators in San Francisco reviewed the records for 247 IE episodes, of which 184 (74%) occurred in IDUs. Information about type of drug used was available for 169 patients. Heroin was the most commonly used drug, followed by cocaine and amphetamines (145, 82, and 33 patients, respectively). S. aureus was the predominant pathogen, accounting for 57% of all episodes.
IE episodes caused by S. aureus were…