Considerations in the Diagnosis and Management of Lower-Extremity Infections in Injection Heroin Users: A Case Series.
J Am Podiatr Med Assoc
; 109(6): 437-444, 2019 Nov.
Article
en En
| MEDLINE
| ID: mdl-31755766
ABSTRACT
BACKGROUND:
On a national level, heroin-related hospital admissions have reached an all-time high. With the foot being the fourth most common injection site, heroin-related lower-extremity infections have become more prevalent owing to many factors, including drug preparation, injection practices, and unknown additives.METHODS:
We present a 16-month case series in which eight patients with lower-extremity infections secondary to heroin abuse presented to The Jewish Hospital in Cincinnati, Ohio.RESULTS:
Three cases of osteomyelitis were seen. All of the infections were cultured and yielded a wide array of microbes, including Staphyloccoccus, Streptococcus, Bacillus, Serratia, Prevotella, and Eikenella. All of the patients were treated with intravenous antibiotic agents, with nearly all receiving combination therapy. Seven of the eight patients underwent surgery during their hospital stay, with two undergoing amputation. Only half of the patients followed up after discharge.CONCLUSIONS:
This case series brings to light many considerations in the diagnosis and management of the heroin user, including multivariable attenuation of immunity, existing predisposition to infection backed by unsterile drug preparation and injection practices, innocuous presentation of deep infections, microbial spectrum, and recommendations on antimicrobial intervention, noncompliance, and poor follow-up. By having greater knowledge in unique considerations of diagnosis and treatment, more efficient care can be provided to this unique patient population.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Osteomielitis
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Abuso de Sustancias por Vía Intravenosa
/
Infecciones de los Tejidos Blandos
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Dependencia de Heroína
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Guideline
Límite:
Adult
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Am Podiatr Med Assoc
Asunto de la revista:
PODIATRIA
Año:
2019
Tipo del documento:
Article