Endocarditis in heroin addicts.

Heroin addicts who inject the drug intravenously rarely take any aseptic precautions (Louria, Hensle, and Rose, 1967; Bewley, Ben-Arie, and James, 1968). Syringes and needles are used and re-used without sterilization; frequently they are shared with other addicts. Skin cleansing is most unusual. The heroin is often adulterated with other powders and the injection prepared with unsterile or contamin- ated water; occasionally, saliva is used. Not sur- prisingly, local infection and thrombophlebitis are common, and systemic sepsis and bacterial endo- carditis may follow. The actual incidence of endocarditis is uncertain but it does not appear to be high. Hussey and Katz (1950), for example, described 102 admissions to hospital for the com- plications of narcotic addiction in a 9-year period, of which 8 were for endocarditis. Again, Cherubin (1967), in his survey of 361 deaths occurring in