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Background: The objective of study is to describe of clinic, microbio- logical and histological data of five cases of infective endocarditis (IE) with Osler's nodes in intravenous drug users . Patients y methods: Prospectively, 43 cases of IE in intravenous drugs users was revised. In 4 patients, a aspirate puncture of Osler's node was performed and in one patient a biopsy of Osler's node was done with Gram's stain and culture of specimen. Results: From 43 episodes of IE, 33 were right-side IE, 9 left-side y 1 right and left side. No patients with right-side IE presented Osler's nodes, however five of 10 (50%) patients with left-side endocarditis. In all of cases grampositive cocci were observed in Gram's strain and Staphylococcus aureus growth on culture of lesion with the same anti- biotype than isolated from blood culture. One case a cutaneous biopsy was performed, and inflammatory infiltrate with necrosis was found. Conclusions: The Gram's strain and culture of specimen aspirated from Osler's nodes were of high utility in the diagnosis of IE in intrave - nous drugs users. The presence of Osler's nodes in a patient with infecti - ve endocarditis must be suggest that the location in left-side. These data suggest that Osler's nodes in infective endocarditis by S. aureus in intra - venous drugs users was originated by microvascular septic emboli.

Utilidad diagnóstica de los nódulos de Osler en la endocarditis infecciosa en usuarios de drogas por vía parenteral (UDVP)