heroin and Pulmonary-Embolism

We report three cases of tricuspid valve infective endocarditis associated with intravenous nyoape use. Nyoape is a variable drug combination of an antiretroviral (efavirenz or ritonavir), heroin, metamphetamines and cannabis. Its use is becoming increasingly common among poor communities in South Africa. All our patients were young HIV-positive men from disadvantaged backgrounds. They all presented with tricuspid regurgitation and septic pulmonary emboli. They were treated with prolonged intravenous antibiotic courses, and one required referral for surgery.

Topics: Adult; Alkynes; Anti-Bacterial Agents; Benzoxazines; Cannabis; Cyclopropanes; Endocarditis; Heroin; HIV Infections; Humans; Illicit Drugs; Male; Methamphetamine; Pulmonary Embolism; Ritonavir; South Africa; Substance-Related Disorders; Tricuspid Valve; Tricuspid Valve Insufficiency; Young Adult

Two cases of pneumothorax secondary to pulmonary septic infarctions occurred in the course of tricuspid endocarditis in intravenous drug misusers. This unusual complication must be considered in patients with right sided endocarditis who develop pleuritic chest pain, haemoptysis, or breathlessness.

Topics: Adult; Endocarditis, Bacterial; Heroin; Humans; Male; Pneumothorax; Pulmonary Embolism; Substance Abuse, Intravenous; Tricuspid Valve

Topics: Adolescent; Adult; Drug Administration Routes; Drug Contamination; Female; Heroin; Heroin Dependence; Humans; Injections, Intravenous; Lung; Male; Pulmonary Embolism; Radionuclide Imaging; Respiratory Function Tests; Substance-Related Disorders; Talc

We report a unique complication of intravenous drug abuse, central embolization of a needle from a peripheral site. A heroin addict dislodged a needle into the soft tissues of the forearm during self injection. Immediate surgical attempts to visualize and remove the needle were unsuccessful. On a subsequent admission, chest radiograph showed the needle in the right mid-lung field. No attempt at removal was made.

Topics: Adult; Foreign Bodies; Foreign-Body Migration; Heroin; Humans; Injections, Intravenous; Male; Needles; Pulmonary Embolism; Radiography

Drug-induced lung diseases may present themselves as bronchial reactions (e.g. bronchial asthma), diseases of the parenchyma (e.g. pulmonary infiltrates with eosinophilia, diffuse fibrosing alveolitis), of the pulmonary vasculature (vasculitis) and of the pleura (e.g. pleurisy or pleural fibrosis). Pathogenetically the two most pertinent types of reaction are hypersensitivity or toxic reactions, and less often biologic reactions such as opportunistic infections after cytotoxic and immunosuppressive therapy. Many drug-induced respiratory diseases are reversible upon withdrawal of the offending agent; others may be irreversible or even progress.

Topics: Aspirin; Asthma; Bronchitis; Busulfan; Contraceptives, Oral, Hormonal; Dose-Response Relationship, Drug; Drug Hypersensitivity; Drug Interactions; Drug Tolerance; Heroin; Humans; Iodides; Lung Diseases; Methysergide; Pituitary Hormones, Posterior; Pleural Diseases; Polyarteritis Nodosa; Pulmonary Edema; Pulmonary Embolism; Pulmonary Eosinophilia; Trypsin

Topics: Adolescent; Adult; Brain Edema; Female; Hepatitis, Viral, Human; Heroin; Heroin Dependence; Humans; Male; Pulmonary Edema; Pulmonary Embolism

Topics: Acute Kidney Injury; Arrhythmias, Cardiac; Chemical and Drug Induced Liver Injury; Electrocardiography; Female; Fetal Diseases; Fetus; Heart Diseases; Hepatitis A; Heroin; Heroin Dependence; Humans; Hypertension, Pulmonary; Injections, Intramuscular; Injections, Intravenous; Injections, Subcutaneous; Lung Diseases; Male; Maternal-Fetal Exchange; Methods; Neurologic Manifestations; Pneumonia, Aspiration; Pregnancy; Pulmonary Edema; Pulmonary Embolism; Respiratory Insufficiency; Skin Diseases

Complications resulting from drug abuse more frequently affect the lung than any other organ. The spectrum of pulmonary complications associated with drug abuse is wide. The current practice of using mixtures of drugs is mainly responsible for the increase in pulmonary complications. The chief complications observed in a series of 241 drug abuse patients were aspiration pneumonitis (12.9 percent), pulmonary edema (10.0 percent), and pneumonia (7.5 percent).

Topics: Adult; Alcoholism; Barbiturates; Cannabis; Cocaine; Coma; Female; Heroin; Humans; Lung Abscess; Lung Diseases; Male; Pneumonia; Pneumonia, Aspiration; Pulmonary Atelectasis; Pulmonary Edema; Pulmonary Embolism; Pulmonary Fibrosis; Substance-Related Disorders

Topics: Aneurysm, Infected; Arterial Occlusive Diseases; Cardiomegaly; Edema; Endocarditis, Bacterial; Hand; Heroin; Humans; Injections, Intra-Arterial; Injections, Intravenous; Ischemia; Lung Diseases; Lymphadenitis; Pneumonia; Pneumonia, Aspiration; Pulmonary Edema; Pulmonary Embolism; Substance-Related Disorders; Tuberculosis, Pulmonary; Vascular Diseases; Venous Insufficiency

Topics: Acute Kidney Injury; Adolescent; Adult; Aged; Anti-Bacterial Agents; Endocarditis, Bacterial; Enterobacteriaceae Infections; Female; Gastrointestinal Hemorrhage; Hemiplegia; Heroin; Heroin Dependence; Humans; Male; Middle Aged; Prospective Studies; Pseudomonas Infections; Pulmonary Embolism; Respiratory Insufficiency; Splenomegaly; Staphylococcal Infections; Streptococcal Infections; Substance-Related Disorders

Topics: Acidosis; Acidosis, Respiratory; Airway Obstruction; Carbon Dioxide; Heroin; Humans; Hypercapnia; Hypothyroidism; Hypoventilation; Hypoxia; Lung Diseases, Obstructive; Neuromuscular Diseases; Oxygen; Pulmonary Alveoli; Pulmonary Circulation; Pulmonary Edema; Pulmonary Embolism; Respiration; Respiratory Insufficiency; Ventilation-Perfusion Ratio; Work of Breathing

Topics: Abscess; Adult; Autopsy; Diagnosis, Differential; Disseminated Intravascular Coagulation; Endocarditis, Bacterial; Heroin; Humans; Infarction; Kidney Diseases; Lung Abscess; Male; Myocardium; Pleural Effusion; Pulmonary Embolism; Splenic Diseases; Splenic Infarction; Staphylococcal Infections; Staphylococcus; Substance-Related Disorders; Tricuspid Valve

Topics: Adult; Amphetamine; Barbiturates; Foreign Bodies; Granuloma; Heroin; Humans; Lung; Lung Diseases; Male; Microscopy, Electron; Pulmonary Embolism; Substance-Related Disorders

Topics: Adult; Aneurysm; Aneurysm, Infected; Endocarditis, Bacterial; Female; Heroin; Humans; Hypertension, Pulmonary; Injections, Intravenous; Lung Diseases; Male; Methylphenidate; Middle Aged; Pneumonia; Pneumonia, Aspiration; Pulmonary Edema; Pulmonary Embolism; Radiography; Substance-Related Disorders; Thrombophlebitis; Thrombosis; Tuberculosis, Pulmonary; Vascular Diseases

Topics: Adult; Anti-Bacterial Agents; Bacteroides; Bacteroides Infections; Endocarditis, Bacterial; Escherichia coli Infections; Heroin; Humans; Injections, Intravenous; Male; Pulmonary Embolism; Staphylococcal Infections; Streptococcal Infections; Substance-Related Disorders

Topics: Adult; Candidiasis; Endocarditis; Heroin; Humans; Injections, Intravenous; Male; Morphine Dependence; Pseudomonas Infections; Pulmonary Embolism; Staphylococcal Infections; Sterilization; Tricuspid Valve