Septicemia in Narcotic Addicts

Abstract

An account is given of 18 narcotic addicts with septicemia. The microorganism most frequently implicated was penicillinase-producing Staphylococcus aureus, sensitive to methicillin. Alpha-hemolytic streptococci were also frequent. Pneumococci were involved in 2 cases. 11 patients had pulmonary disease. Pneumonia occurred in 4 patients, in 7 the pulmonary involvement was probably of embolic origin. Embolic episodes were noted also in other organs: in 2 cases in the brain, in 2 in the mesenterial region, in 4 in the liver, in 4 in the kidneys, and in 2 or possibly 4 cases in the skin. Endocarditis was noted in at least 3 cases, involving the tricuspid valve in at least 2 cases and the aortic valve in 1 case. Two patients had acute hepatitis, both succumbed. Signs of liver damage were present in most patients. Early and adequate use of antibiotics had a remarkably beneficial effect and may account for the high recovery rate: all but 3 patients survived the acute stage. As the prevailing causative agents of septicemia in drug addicts are penicillin-resistant staphylococci, penicillinase-resistant penicillin is recommended until the results of cultures and sensitivity tests are available.