| Abstract: | Six hundred patients from a Washington, D.C. population of 20,000 heroin addicts were admitted to D.C. General Hospital between November 1967 and April 1971. Bacterial endocarditis was found in 50 of them (8 per cent). The presenting features were fever (50 patients), pulmonary embolism (32 patients), positive blood cultures (39 patients), subcutaneous abscesses (2 patients), empyema (1 patient), septic arthritis (1 patient) and pericardial effusion (1 patient). The tricuspid valve alone was involved in 36 patients (72 per cent) and with other valves in 6 patients. Staphylococcus aureus was found in 28 patients, Streptococcus viridans in 4 and Streptococcus faecalis in 3. There was an over-all mortality rate of 28 per cent but pure right-sided lesions were found in only 16 per cent (6 of 38 patients). Attention to the auscultatory features of acute tricuspid regurgitation was the predominant factor leading to early diagnosis. |
