heroin and Central-Nervous-System-Diseases

Topics: Acquired Immunodeficiency Syndrome; Amphetamines; Animals; Borrelia Infections; Central Nervous System Diseases; Central Nervous System Neoplasms; Cocaine; Cytomegalovirus Infections; Heroin; Herpesviridae Infections; Humans; Lymphoma; Lymphomatoid Granulomatosis; Meningitis; Meningitis, Fungal; Mycoses; Neurosyphilis; Sympathomimetics; Vasculitis

Topics: Altitude Sickness; Central Nervous System Diseases; Dextropropoxyphene; Drowning; Ethchlorvynol; Hemodynamics; Heroin; Humans; Lung; Oxygen; Pancreatitis; Pulmonary Edema; Respiratory Distress Syndrome; Respiratory Therapy; Salicylates; Smoke; Syndrome

Fungal nervous system infection can be a difficult diagnosis to make, due to the fact that there are no specific manifestations of the disease and laboratory confirmation is difficult to confirm.. We report a young male who presented to our emergency department with a variety of unilateral visual field complaints. While he initially denied recent IV drug abuse, his physical examination was highly suggestive of a fungal infection known to result from brown heroin use. He was ultimately diagnosed with meningitis, ventriculitis, and endogenous endophthalmitis believed to result from a Candida species. The response to treatment with vitrectomy and broad-spectrum antimicrobials gave support to the presumed diagnosis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We provide a rarely described report of a possible complication from the use of IV brown heroin that led to a central nervous system infection involving vision loss by fungal infection.

Topics: Antifungal Agents; Candida; Central Nervous System Diseases; Cerebral Ventriculitis; Diagnosis, Differential; Emergency Service, Hospital; Endophthalmitis; Heroin; Humans; Male; Meningitis; Mycoses; Substance Abuse, Intravenous; Visual Fields; Voriconazole; Young Adult

Topics: Acute Kidney Injury; Adult; Central Nervous System Diseases; Drug Overdose; Female; Heroin; Humans; Narcotics; Pregnancy; Pregnancy Complications; Pregnancy Outcome

Topics: Altitude; Brain Injuries; Central Nervous System Diseases; Heart Failure; Heroin; Humans; Hypoxia; Pulmonary Edema; Shock; Substance-Related Disorders