heroin and Skin-Diseases--Bacterial

Topics: Epidemics; Heroin; Humans; Narcotics; Skin Diseases, Bacterial; Soft Tissue Infections; Substance Abuse, Intravenous; United States

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

Wound botulism is a rare infectious and toxicologic complication of trauma and i.v. drug abuse. Only 39 cases have been reported in detail in the English literature. This case report describes a patient with wound botulism who presented to four medical facilities before receiving definitive diagnosis and treatment. Although his history and physical examination were consistent with wound botulism, diagnosis and therapy were delayed because this rare disease was not considered initially in the differential diagnosis. Wound botulism should be considered in trauma patients and i.v. drug abusers who present with cranial nerve palsies and descending paresis.

Topics: Abscess; Adult; Botulism; Clostridium botulinum; Diagnostic Errors; Heroin; Humans; Male; Skin Diseases, Bacterial; Substance-Related Disorders; Wound Infection