Clinical characteristics and outcome of infective endocarditis among intravenous drug abusers in India

ABSTRACT Introduction Infective endocarditis(IE) is the most dreaded complication of intravenous drug abuse(IVDA).IVDA is present in significant proportions in India. Since there is scarcity of Indian data on IVDA associated IE, we report a study comparing IVDA to non IVDA associated IE.We compare differences in clinical profile, microbiology, echocardiography and clinical outcome from a tertiary care hospital. Methods A total of 133 patients admitted from 1st January 2017 to 31st December 2019 who met the Modified Duke ‘‘definitive’’ criteria for IE were included.Detailed Information was collected regarding demography, clinical data and laboratory investigations.All patients underwent transthoracic echocardiography and trans-esophageal echocardiogram wherever necessary. Results Among a total of 133 patients, 54 patients(40.6%) were iv drug abusers.Patients in IVDA-group were younger, mostly males, more likely to have concomitant HCV and HIV infections compared to non IVDA-group.Chronic comorbidities such as DM and CKD were more common in non IVDA-group.Rate of positive blood culture was higher in IVDA-group compared to non IVDA-group(74.1v/s 32.9%,P Conclusion IVDA-IE is a significant problem in India.Demographic, microbiological and echocardiographic profile is quite different in IVDA and non IVDA-group.There is urgent need to conduct larger studies.