Spritzenabszesse bei intravenös Drogenabhängigen

Abstract

Surgeons treating abscesses caused by intravenous drug use must be aware of the higher rate of associated complications after injection in the lower extremities. Prevention in drug addiction programs could reduce complications and costs related to drug use by avoiding injection sites on the lower extremities.

Skin alterations due to illegal drug abuse

“…The pathogens include besides Staphylococcus aureus various streptococci species such as Streptococcus milleri and α‐hemolytic streptococci (Figure 1). Gram‐negative bacteria (such as Pseudomonas aeruginosa, Escherichia coli, Enterobacter cloacae, Proteus vulgaris, Klebsielleae, Hemophilus) and anaerobic species (Bacteroides, Fusobacterium, Eikenella corrodens ) are more characteristic for specific drugs or forms of application [1, 2]. For example, the occasionally practiced licking or blowing out the injection needle before injection doubles the risk of infection with resident bacteria of the oral flora (e. g. streptococci and anaerobes).…”

“…Abscess‐forming cutaneous infections by cMRSA (community‐associated methicillin‐resistant S. aureus ) are also found among drug addicts. Especially in the event of non‐response to antibiotics or frequently recurrent skin or soft tissue infections colonization with these bacteria must be considered [1, 2].…”

“…drug addicts. Especially in the event of non-response to antibiotics or frequently recurrent skin or soft tissue infections colonization with these bacteria must be considered [1,2]. Bacterial skin and soft tissue infections such as abscesses, erysipelas or phlegmons belong to the most frequent complications in drug addicts with an incidence of 10-30 %.…”

“…In addition to lack of experience in handling needles, their repeated use as well as lack of hygiene, frequent and intensive drug consumption, an HIV infection, malnutrition as well as bacterial contamination of the drugs or their additives can promote the development of cutaneous infections. Alternative injection techniques such as “skin popping” (subcutaneous injections when intravenous approach is unavailable), “booting” (drawing blood into the syringe before the injection) and injection of so‐called “speedballs” (heroin and cocaine) can also promote infections [1–4]. The most common injection site is the antecubital fossa followed by the arms and hands.…”

35-jähriger Mann mit Komplikationen nach intravenösem Drogenkonsum

“…Haut-und Weichteilinfektionen sind der häufigste Hospitalisierungsgrund von i. v.-Drogenkonsumenten [1,2]. Punktionen an der unteren Extremität sind überdurchschnittlich häufig mit Komplikationen vergesellschaftet [1]. Multiple Infektionsherde [2] sollten bei der Fokussuche insbesondere bei protrahiertem Verlauf in Betracht gezogen werden.…”