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Skin and soft tissue infections in injection drug users.
Abstract
Skin and soft tissue infections are the most common cause for hospital admission of injection drug users. Cutaneous and subcutaneous abscesses are the most frequent type of SSTI and occur most commonly when drug users are no longer able to inject intravenously and resort to injection directly into skin or muscle. Abscesses may be difficult to differentiate from uncomplicated cellulitis or may be confused with pseudoaneurysms, hematoma, phlegmon, or thrombosed vein. Special studies, including ultrasonography; CT scans, and MR imaging; or careful incision and inspection may be necessary to clarify the extent of infection and the presence of abscess. These procedures may also help differentiate a subcutaneous abscess from a vascular structure. Uncomplicated cellulitis most commonly responds to antibiotic therapy directed toward Staphylococcus aureus and Streptococcus spp. In several recent studies, cutaneous and subcutaneous abscesses have been found to be caused by polymicrobial infections and to include anaerobic organisms as well as aerobic gram-positive cocci in a little more than 50% of cases. Complete, often repeated, incision and drainage is a prerequisite for successful outcome in these cases. Complications of SSTI are many and are potentially life threatening. They include direct extension of subcutaneous abscess into vital areas or structures, necrotizing fasciitis and myositis, bacteremia, and sepsis. An outbreak of a highly lethal SSTI that recently occurred in Scotl…
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In the citing paper
“Other possible risk factors for abscesses include skin-popping, defined as direct subcutaneous injection, and kicking (also known as booting or jacking), defined as injecting the drug into the vein, pulling blood into the syringe and then injecting it back into the vein (Binswanger, Kral, Bluthenthal, Rybold, & Edlin, 2000; Ebright & Pieper, 2002; Murphy et al., 2001; Phillips & Stein, 2010).”
From High Rates of Abscesses and Chronic Wounds in Community-Recruited Injection Drug Users and Associated Risk Factors (2015) · cites this paper as Ebright & Pieper, 2002
In the citing paper
“Prior studies have suggested that women are at increased risk for developing abscesses (Ebright & Pieper, 2002; Fink, Lindsay, Slymen, Kral, & Bluthenthal, 2013; Hope, Marongiu, Parry, & Ncube, 2010; Lloyd-Smith et al., 2005; Lloyd-Smith et al., 2008; Spijkerman, van Ameijden, Mientjes, Coutinho, & van den Hoek, 1996)”
From High Rates of Abscesses and Chronic Wounds in Community-Recruited Injection Drug Users and Associated Risk Factors (2015) · cites this paper as Ebright & Pieper, 2002
In the citing paper
“Injection-related wounds, including abscesses and chronic wounds are significant causes of morbidity for injection drug users (IDUs) (Ebright & Pieper, 2002; Palfreyman et al., 2007).”
From High Rates of Abscesses and Chronic Wounds in Community-Recruited Injection Drug Users and Associated Risk Factors (2015) · cites this paper as Ebright & Pieper, 2002
In the citing paper
“Vaso-constricting drugs, such as cocaine, injected either alone or in combination with heroin (i.e. speedballing) may induce vasospasm and thrombosis, leading to tissue necrosis (Ebright & Pieper, 2002; Hope et al., 2010; Murphy et al., 2001; Phillips & Stein, 2010; Spijkerman et al., 1996).”
From High Rates of Abscesses and Chronic Wounds in Community-Recruited Injection Drug Users and Associated Risk Factors (2015) · cites this paper as Ebright & Pieper, 2002
Citations
Cites
Binswanger, I. A., Kral, A. H., Bluthenthal, R. N., Rybold, D. J., & Edlin, B. R. (2000) · Clinical Infectious Diseases · doi:10.1086/313703 · Cited by 300
Risk Factors for Skin and Soft‐Tissue Abscesses among Injection Drug Users: A Case‐Control Study
Murphy, E. L., DeVita, D., Liu, H., Vittinghoff, E., Leung, P., Ciccarone, D. H., & Edlin, B. R. (2001) · Clinical Infectious Diseases · doi:10.1086/320879 · Cited by 262
Spijkerman, I. J. B., van Ameijden, E. J. C., Mientjes, G. H. C., Coutinho, R. A., & van den Hoek, A. (1996) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(96)00180-1 · Cited by 137
Schnall, S. B., Holtom, P. D., & Lilley, J. C. (1994) · The Journal of Bone & Joint Surgery · doi:10.2106/00004623-199410000-00012 · Cited by 28
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Metadata
- Authors
- Ebright, J. R., & Pieper, B.
- Venue
- Infectious Disease Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2002-09
- Volume
- 16
- Issue
- 3
- Pages
- 697-712
- ISSN
- 0891-5520
- Cited by
- 164
- References
- 4
- Language
- en
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