heroin and Cellulitis

Cutaneous anthrax usually has a mortality rate of less than 1 per cent. However, since December 2009 there have been more than 13 deaths in the UK due to anthrax-contaminated heroin. We therefore wish to raise clinical awareness of this treatable disease.. We describe the case of a heroin user with an equivocal presentation of cellulitis in the neck. Within 36 hours, this led to death due to cutaneous anthrax.. Whilst cutaneous anthrax remains rare, this case report aims to raise awareness of the fact that the symptoms and signs of this condition in intravenous drug users may not always fit the typical picture.

Topics: Adult; Anthrax; Bacillus anthracis; Cellulitis; Heroin; Humans; Male; Skin Diseases, Bacterial; Substance Abuse, Intravenous

We present an unusual case of breast ulceration secondary to heroin injection in a pregnant woman.

Topics: Adult; Breast Diseases; Cellulitis; Female; Heroin; Heroin Dependence; Humans; Narcotics; Necrosis; Pregnancy; Pregnancy Complications; Ulcer

Concern exists over recent unexplained deaths among intravenous drug users. This report describes a patient with crepitant cellulitis who was admitted complaining of severe pain in the right forearm. Ultrasonography demonstrated gas in the tissues and he was referred for early surgical debridement of the arm. He was treated with intravenous benzyl penicillin, gentamicin and metronidazole and made a full recovery. Aspirate samples grew Bacillus cereus, morphologically similar to the isolate obtained from a sample of the patient's own heroin. Antibiogram and API 50CHB profiles were also similar. Further typing included 'H' flagellar serotyping, which found both blood and heroin strains to be non-typable, and amplified fragment polymorphism analysis, which showed that the strains were indistinguishable. Genotyping of two selected genes from B. cereus confirmed almost certain identity between the two strains. This case illustrates the potential virulence of B. cereus when inoculated into tissues, and to our knowledge, is the first report to demonstrate a conclusive microbiological link between contaminated heroin and serious sepsis in a drug user due to B. cereus.

Topics: Adult; Anti-Bacterial Agents; Bacillus cereus; Cellulitis; Forearm; Genotype; Gentamicins; Heroin; Humans; Injections, Intravenous; Male; Metronidazole; Pain; Penicillins; Substance Abuse, Intravenous; Ultrasonography

Drug addiction is linked with increased prevalence of various illnesses. Of major importance are skin diseases which often have a powerful influence on the health. Analysis of the situation in Switzerland at the outset of the 1990s showed that not all drug addicts could be reached with the existing range of treatments. For this reason, heroin-supported treatment was examined as a new therapy option from 1994 on. The influence on the skin's health are examined in this study. The minimum age of those admitted was set at age 20. Heroin addiction had to date back at least two years, and several treatment efforts had to have failed. Data of 1,035 patients was based on tests at admission and after six, 12, and 18 months of treatment. Some 18% of drug consumers indicated abcesses at admission, and almost 30% showed phlegmones. The prevalence of all skin diseases examined show significant declines over the 18 months of treatment. The relative risk resulting from puncture points fell to 0.35 (SD: 0.26-0.47), from phlegmones to 0.24 (SD: 0.14-0.41), from absesses to 0.31 (SD: 0.15-0.60). This study shows that skin diseases are a frequent and important complication among intravenous drug addicts. Heroin-supported treatment led to favourable progress of the dermatological situation among patients.

Topics: Abscess; Adult; Cellulitis; Comorbidity; Cross-Sectional Studies; Female; Heroin; Heroin Dependence; Humans; Incidence; Male; Skin Diseases, Infectious; Substance Abuse, Intravenous; Switzerland

The purpose of this paper is to emphasize the importance of heroin injections in the neck as an etiology of superficial and deep neck infections and to familiarize the otolaryngologist with the problems in the diagnosis and management of such infections. This study represents the first series to be reported in the world literature of patients with neck infections secondary to heroin injections. Fifty-seven patients with neck infections related to injection of heroin in the neck (main-lining) were studied. These patients were admitted to Detroit General Hospital during the three-year period between January 1974 and December 1976. The clinical signs and symptoms, location of the abscesses, soft tissue radiographs of the neck, arteriograms and ultrasound examinations of the neck are discussed. The diagnostic evaluation and the treatment of the heroin addict who presents with an inflammatory neck mass are outlined, emphasizing the difficulty and the importance of differentiating between cellulitis, abscess, and pseudoaneurysms of the carotid and subclavian arteries.

Topics: Abscess; Adult; Aneurysm; Carotid Artery Diseases; Cellulitis; Diagnosis, Differential; Edema; Female; Heroin; Heroin Dependence; Humans; Male; Middle Aged; Neck; Subclavian Artery

Topics: Adult; Anesthesia; Cellulitis; Female; Hepatitis A; Heroin; Humans; Male; Maternal-Fetal Exchange; Menstruation Disturbances; Physician-Patient Relations; Pregnancy; Pulmonary Edema; Substance-Related Disorders; Surgical Procedures, Operative; Tetanus

Topics: Adolescent; Adult; Cellulitis; Death Certificates; Ethnicity; Female; Hepatitis; Heroin; Hospitalization; Humans; Injections, Intravenous; Male; Middle Aged; Morphine; Narcotics; New York City; Pulmonary Edema; Seasons; Substance-Related Disorders

Topics: Abscess; Arthritis; Arthritis, Infectious; Bacteroides; Benzoates; Brain Abscess; Camphor; Cellulitis; Endocarditis; Endocarditis, Bacterial; Endocarditis, Subacute Bacterial; Hepatitis; Hepatitis B virus; Heroin; Humans; Infections; Meningitis; Methicillin; Opium; Penicillin G; Pneumothorax; Sepsis; Staphylococcal Infections; Substance-Related Disorders; Toxicology