Disseminated candidiasis in addicts who use brown heroin: Report of 83 cases and review

Josep Bisbe, Josep M. Miro, Xavier Latorre, Asuncion Moreno, Josep Mallolas, Josep M. Gatell, Jordi de la Bellacasa Puig, Eladio Soriano

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From November 1983 to April 1990, disseminated candidiasis was diagnosed in 83 heroin addicts at our institution. All patients had consumed brown heroin diluted in fresh lemon juice. Sixty-two (75%) had skin lesions, 41 (49%) had ocular lesions, and 35 (42%) had one or several costochondral tumors. Candida albicans was grown in culture or histopathologically identified in 34 cases (41%). The patients who had only cutaneous lesions were treated with ketoconazole, and they were all cured. The patients with ocular involvement received systemic amphotericin B with or without oral flucytosine; 29 of these patients developed varying degrees of vision loss. The method of treatment of costochondral tumors was not uniform; in 14 cases the lesions were resected. The one patient who died developed endocarditis involving the aortic valve. Cases of pleuropulmonary involvement, spondylitis, and large-joint arthritis have also been described among the 300 cases reported in the reviewed literature. This is a new syndrome of candidal infection in drug addicts who use brown heroin; ocular lesions are the most harmful manifestation, and loss of vision is the major sequela.

Idioma originalAnglès
Pàgines (de-a)910-923
Nombre de pàgines14
RevistaClinical Infectious Diseases
Estat de la publicacióPublicada - de des. 1992
Publicat externament


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