Neurological complications of endocarditis in persons taking drugs intravenously.

A study was made of 46 cases of endocarditis in persons known to take drugs intravenously. Findings included significantly lower ages for those patients in whom infections were right-sided. The neurological complication rate was 39 percent overall and 58 percent in the left-sided group. Neurological complications are unusual in right-sided infection. In about a third of those with neurological complications there were sensorial changes without focal signs. Despite a high mortality, neurological complications in Group D streptococcal endocarditis were relatively infrequent. One case is presented in which a foreign body may have contributed to the formation of the embolic material. The clinical and neuropathological features encountered are compared with those reported in persons with endocarditis who were not addicts. The review indicates that neurological complications in nonaddicts and in addicts are similar in type but are more common and severe in addicts.