Uteshev A.

Uteshev AA Karabinenko E. N. Filatov GI Storozhakov, corresponding member. Academy of Medical Sciences, Doctor of Medical Sciences, Medical University, BUT IF IFL number 1 AMO ZIL, Moscow According to official Ministry of Health, in recent years in our country has seen a significant increase in drug abuse, especially among young people aged 14-25 years. In this regard, of particular relevance at present is the problem of so-called "syringe" infections, the most common, HIV infection, viral hepatitis B and C, bacterial hematogenous infection, causing severe septic complications - bacterial endocarditis, pneumonia, septicemia [1 ]. Individuals who use drugs, often intravenously developed septic process, caused by Staphylococcus aureus [2]. As a clinical examples present two characteristic cases of flow "syringe" infection in young women with heroin addiction. These observations, in our view, can help practitioners become acquainted with the peculiarities of the clinical manifestations of such complications in drug addicts. Observation of the first. Patient B., aged 23, was admitted to hospital 12/12/1999 with the diagnosis of acute pyelonephritis, a right-sided pneumonia? ". The patient on admission complained of constant intense pain in the left lumbar region radiating to the left buttock, general weakness, insomnia, chills, fever to 39-40 ° C. The above symptoms occurred in a patient five days before hospitalization. In history - heroin addiction for seven years. The presence of myalgia in a patient was regarded as a drug "breaking". The clinical picture was dominated by intoxication syndrome with hectic nature of the temperature curve and persistent arterial hypotension (Fig. 1). When echocardiography was found: the cavity of the heart is not enlarged, the ejection fraction - 70%, tricuspid valve on the wing - vegetation is 10-15 mm in systole, prolapses into the right ventricle. Tricuspid regurgitation II degree. According to echocardiography, it was impossible to eliminate the gap of generations of small chords. On the radiograph of the chest in three projections revealed multiple foci of destruction with slight perifocal reaction and an increase in mediastinal, paratracheal and peribronchial lymph nodes on both sides, the fluid in the right pleural cavity, reaching to V edges. According to the ultrasound of the abdominal cavity was determined moderate hepatosplenomegaly. In laboratory analysis indicated a moderate increase in serum transaminases, a slight increase in the level of total bilirubin with a slight increase in the level ostrofaznyh proteins. When blood cultures and sputum pathogenic organisms have been identified. The patient ELISA identified antibodies to hepatitis B and C. Given the severity of the patient began to pursue an active parenteral antibiotic therapy (vancomycin, tsefabol) in combination with detoxification treatment. In the mental status of patients with negative, little information (with difficulty was in contact), from the proposed treatments and surveys are actively refused, despite the explanations concerning the seriousness of the further prognosis and possible outcome of the disease.