Emergence of recreational drug abuse as a major risk factor for stroke in young adults

Article Abstract:

To learn more concerning the relationship between recreational drug abuse (excluding marijuana and commonly prescribed drugs) and stroke (sudden loss of blood to a region of the brain, due to hemorrhage or a clot), the medical records were reviewed of 214 patients between 15 and 44 who had been admitted to a hospital with that diagnosis during a 10-year period. Data concerning their drug habits were compared with similar data for an age- and sex-matched group (controls) of 214 patients admitted with other diagnoses. Strokes were considered drug-related if they occurred within six hours of drug administration or if the patient tested positive for drugs after hospital admission in a coma. They were also considered drug-related if caused by a clot or other disorder resulting from infections caused by intravenous drug abuse. Results showed that people with cardiac conditions had 7.3 times greater risk for stroke, while drug abusers had a relative risk of 6.5, and people with diabetes mellitus or hypertension at the next lowest levels of risk. The risk for stroke was highest during the six hours after drug use, after which it decreased. Eighty-seven patients were younger than 35: for this subgroup, drug abuse was the most common condition predisposing them to stroke. Seventy-three stroke patients were recreational drug abusers, and, for 47 of these, a strong association was found between their drug use and stroke. Cocaine was used most commonly by these 47, then heroin, amphetamine, methylphenidate, and phencyclidine. Twenty-six percent of the stroke patients (56 people) died in the first phase of their hospital admission, the majority as a result of hemorrhage in the brain. Mortality among drug abusers was higher than nonabusers (36 versus 23 percent). The results show that recreational drug abuse is an important risk factor for stroke. Previous studies may have found it to be less significant because they did not survey large urban areas, such as the one studied here. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Risk factors, Statistics, Stroke (Disease), Stroke

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Co-infection with human immunodeficiency virus-type 1 (HIV-1) and cytomegalovirus in two intravenous drug users

Article Abstract:

The initial symptoms of infection with the human immunodeficiency virus (HIV) can resemble symptoms of mononucleosis, an illness characterized by fever, fatigue and swollen glands. The sudden, transient illness associated with HIV infection typically involves fever, sweats, muscle and joint pain, rash, diarrhea, and lymphocytic meningitis, the inflammation of membranes in the spinal cord and brain. The cases are described of two intravenous drug users who both developed a severe illness associated with fever, yeast infection of the mouth or throat, weight loss, muscle and joint pain, and fatigue. Symptoms developed two weeks after needle-sharing and lasted 7 to 10 weeks. Blood tests indicated that both patients were infected with cytomegalovirus and HIV-1. Studies have shown that cytomegalovirus enhances the growth and development of HIV-1, and this interaction between the two viruses may worsen disease activity as compared with infection by HIV alone. One patient recovered from the initial illness within six months but had a decreased number of CD4+ lymphocytes, a type of immune or natural defense cell. Lymphadenopathy, or disease of the lymph nodes, persisted after the sudden illness in the other patient, who is feeling well 21 months after the infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Cytomegalovirus infections

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Cerebral microsporidiosis due to Encephalitozoon cuniculi in a patient with human immunodeficiency virus infection

Article Abstract:

Infection with the parasite Encephalitozoon cuniculi may strike those infected with HIV and may be difficult to diagnose and treat. This organism belongs to a class of organisms called microsporidia. A 29-year-old HIV-infected man was admitted to a hospital with the symptoms of a brain disorder. A CT scan revealed lesions in the brain but blood tests for several organisms were negative. After microsporidia spores were detected in his urine and feces, he was treated with an appropriate drug. He initially improved, but subsequently worsened and died.

Health aspects, Infection, Brain, Microsporidia, Microsporida

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