Infections Related to Drug Use (2025-2026 Recording)-Infections Related to Drug Use Recording

Video Transcription

Video Summary

Dr. Katie White’s lecture focused on infections related to drug use, especially among people who inject drugs. She opened with a case of a patient with MRSA tricuspid endocarditis, septic pulmonary emboli, spinal osteomyelitis/discitis, and hepatitis C, illustrating how infectious diseases and addiction often intersect.<br /><br />The talk divided infections into two major groups: bacterial/fungal infections and viral infections. Bacterial and fungal infections usually come from skin, environmental, or injection-related contamination and can progress quickly to serious disease such as endocarditis, osteomyelitis, and abscesses. Viral infections—especially hepatitis C and HIV—are commonly spread through shared needles or paraphernalia and are often chronic and initially silent.<br /><br />A major focus was infective endocarditis. Dr. White explained how to think through the diagnosis and management by asking five questions: right- vs left-sided disease, presence of heart failure, metastatic infection or emboli, native vs prosthetic valve infection, and the causative organism. Right-sided tricuspid endocarditis is more common in PWID and is often less severe than left-sided disease. She reviewed data showing rising endocarditis mortality in young adults, especially since 2014, paralleling the fentanyl overdose epidemic.<br /><br />She also highlighted treatment innovations, including oral antibiotic regimens for selected patients, linezolid use with attention to serotonin syndrome risk, long-acting agents like dalbavancin, and percutaneous valve vegetation debulking (AngioVac). Prevention strategies included harm reduction, syringe services, safe injection education, dental prophylaxis for selected patients, vaccination for hepatitis A and B, and HIV PrEP. She concluded by describing Vanderbilt’s multidisciplinary addiction and infectious diseases programs.

Keywords

drug use infections

people who inject drugs

MRSA endocarditis

tricuspid endocarditis

septic pulmonary emboli

spinal osteomyelitis

hepatitis C

bacterial fungal infections

viral infections

hepatitis C HIV

harm reduction

addiction medicine