Tricuspid valve endocarditis associated with intravenous nyoape use: a report of 3 cases

We report three cases of tricuspid valve infective endocarditis associated with intravenous nyoape use. Nyoape is a variable drug combination of an antiretroviral (efavirenz or ritonavir), heroin, metamphetamines and cannabis. Its use is becoming increasingly common among poor communities in South A...

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Bibliographic Details
Published in:South African medical journal 2014-12, Vol.104 (12), p.853-855
Main Authors: Meel, R, Peters, F, Essop, M R
Format: Article
Language:English
Subjects:
Adult
Anti-Bacterial Agents - therapeutic use
Benzoxazines - administration & dosage
Benzoxazines - adverse effects
Cannabis - adverse effects
Cannabis - chemistry
Care and treatment
Case studies
Complications and side effects
Diagnosis
Endocarditis - drug therapy
Endocarditis - etiology
Heroin - administration & dosage
Heroin - adverse effects
HIV Infections - virology
Humans
Infective endocarditis
Intravenous drug abuse
Male
Methamphetamine - administration & dosage
Methamphetamine - adverse effects
Pulmonary Embolism - etiology
Pulmonary Embolism - pathology
Ritonavir - administration & dosage
Ritonavir - adverse effects
South Africa
Street Drugs - adverse effects
Substance-Related Disorders - complications
Tricuspid Valve - pathology
Tricuspid Valve Insufficiency - drug therapy
Tricuspid Valve Insufficiency - etiology
Young Adult
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Summary:We report three cases of tricuspid valve infective endocarditis associated with intravenous nyoape use. Nyoape is a variable drug combination of an antiretroviral (efavirenz or ritonavir), heroin, metamphetamines and cannabis. Its use is becoming increasingly common among poor communities in South Africa. All our patients were young HIV-positive men from disadvantaged backgrounds. They all presented with tricuspid regurgitation and septic pulmonary emboli. They were treated with prolonged intravenous antibiotic courses, and one required referral for surgery.
ISSN:0256-9574
DOI:10.7196/SAMJ.8291