heroin and Spondylitis

During a recent 5-month period, 16 intravenous heroin users were hospitalized with a previously unrecognized complication of drug abuse. The characteristic symptoms were similar in all patients and included fever, paraspinal myalgias, and periarthritis. There was no evidence of bacterial infection, hepatitis, or drug abstinence as the cause of these musculoskeletal symptoms. Continued heroin use was associated with progressive musculoskeletal symptoms, while discontinuation of heroin use resulted in complete recovery. Antibiotics did not affect the outcome, and the syndrome was self-limited in all hospitalized patients. The pathogenesis of this syndrome is unknown but may be related to the heroin, which was described as brown by the patients, or an adulterant.

Topics: Adult; Anti-Bacterial Agents; Heroin; Heroin Dependence; Humans; Length of Stay; Male; Muscular Diseases; Pain; Periarthritis; Spasm; Spondylitis

Topics: Bacterial Infections; Heroin; Humans; Joint Diseases; Sacroiliac Joint; Spinal Diseases; Spondylitis; Substance-Related Disorders

Topics: Adolescent; Adult; Arthritis, Infectious; Candidiasis; Chronic Disease; Female; Hepatitis; Heroin; Humans; Male; Osteomyelitis; Pseudomonas aeruginosa; Pseudomonas Infections; Sepsis; Spondylitis; Staphylococcal Infections; Substance-Related Disorders

Topics: Adolescent; Adult; Female; Heroin; Humans; Injections; Lung; Lung Abscess; Male; Morphine Dependence; New York City; Pleural Effusion; Pneumonia; Pseudomonas Infections; Pulmonary Edema; Radiography; Spondylitis; Substance-Related Disorders; Tetanus; United States