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IV drug users respond well to endophthalmitis treatment
Intravenous drug users who had endogenous endophthalmitis responded better to treatment than those who did not use drugs, according to a retrospective medical record review.
The researchers said those who did not use drugs fared worse due to more chronic comorbidities and older age.
Investigators chose a large medical center in New Hampshire for its patient population, as the age-related rate of deaths associated with drug use is higher in the state, at 26.2 per 100,000 people, compared to the Northeast regional average of 16.1 per 100,000 people.
During the opioid epidemic from 2012 to 2016, researchers identified 15 patients with endogenous endophthalmitis (EE) (five men and 10 women ranging in age from 24 to 83 years), with nine (56.3%) with a history of IV drug use.
During the study period, the incidence of non-IV drug use EE remained at zero to two cases per year, and the number of IV drug use EE cases ranged from zero to four.
Reduced vision was the most common presenting symptom, found in all nine patients with IV drug use EE and five or six patients with non-IV drug use EE.
Patients with IV drug use were younger, had fewer comorbidities and tended to delay seeking medical care, according to researchers. They also had more negative intraocular and blood culture findings and experienced significantly more improvement in visual acuity after intervention than did patients without IV drug use.
“These observations support the notion that patients with intravenous drug use subvert typical patterns of self-care by normalizing injection-related harms and delaying medical treatment until emergencies occur,” researchers wrote.
The delay in care is a challenge to microbial diagnosis because the injection-induced transient bacteremia may have resolved by time of presentation, they said. – by Abigail Sutton
Disclosure : The authors report no relevant financial disclosures.