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April 26, 1993

Complications of Infective Endocarditis in the 1980s-Reply

Author Affiliations

São Paulo, Brazil

Arch Intern Med. 1993;153(8):1015-1017. doi:10.1001/archinte.1993.00410080073015

We thank Anand for interesting comments about our study.1 It is recognized that intravenous drug abuse creates a new population of patients susceptible to infective endocarditis, with peculiarities in clinical presentation, causative microorganisms, complications, and outcome. However, as we previously reported,2 there were seven episodes of endocarditis in six patients in our series, with a history of intravenous drug abuse. The patients' ages ranged between 16 and 38 years (mean age, 22.28 years); four episodes appeared in female and three episodes in male patients. The causative microorganism was Staphylococcus aureus in six episodes; blood culture specimens were negative in one patient. In five episodes, endocarditis occurred on the tricuspid valve and in two on the mitral valve. Six complications occurred in one patient (respiratory failure, seizure, cardiac arrest, septic pulmonary embolism, renal failure, and nephrotic syndrome), two complications occurred in three patients (septic pulmonary embolism and skin rash