Drug Use and Abscesses

Our data demonstrate that abscesses and cellulitis are extremely prevalent among IDUs in San Francisco. Targeted, early and respectful health services for treatment of abscesses and cellulitis may reduce morbidity and the need for lengthy hospital admissions.

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Abscess

High Prevalence of Abscesses and Cellulitis Among Community-Recruited Injection Drug Users in San Francisco

Heroin Abscess: How Heroin Use Leads To Abscesses

When doing a field block, after the first injection always reinsert the needle through anesthetized skin to minimize the number of painful pricks.

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Antibiotics

A soft-tissue abscess is typically a palpable, tender, red lump containing pus. There is usually localized induration and some “give” with palpation as opposed to the solid feeling of a mass or nodule. (See also Abscesses Abscesses Abscesses are collections of pus in confined tissue spaces, usually caused by bacterial infection. Symptoms include local pain, tenderness, warmth, and swelling (if abscesses are near the skin. read more .)

For breast abscesses, ultrasound-guided needle aspiration, as opposed to formal incision and drainage, is becoming the standard of care.

Antibiotic therapy was started in the emergency room for 85% of the 323 individuals, with similar regimens among injection drug users and non-injection drug users. In a study on 858 participants, most of whom had been injecting for more than 20 years, 37% had current abscesses. Injecting for 20 years or more, 90 or more times per day, heroin use and skin-popping in the last 30 days were all associated with an increased risk of abscess. Of the 457 participants reporting a prior lifetime abscess with some type of treatment, 55% were treated by a doctor, 31% reported self-lancing, 5% reported self-medication with illegally purchased antibiotics and 9% self-treated with some form of homeopathic care (e.g., salt-water soak, hot and cold compresses or application of aloe).

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MRSA Pictures / Staph Infection Pictures/Graphic Images

Chronic draining sinuses and fistulas, secondary to inadequate drainage of deep or complicated abscesses

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Contraindications to Incising and Draining an Abscess

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Clinical Infectious Diseases, Volume 30, Issue 3, March 2000, Pages 579–581, https://doi.org/10.1086/313703

How To Incise and Drain an Abscess

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Prevalence of abscess and/or cellulitis on physical examination among 169 street-recruited injection drug users (IDUs) according to participant characteristics and injection practices.

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Results

Our data suggest that skin-popping is a strong risk factor for abscesses and cellulitis. Skin-popping also appears to be a risk factor for the development of tetanus [ 4] and paralysis associated with Clostridium botulinum toxin [ 5]. The subcutaneous space may be hospitable to multiplying pathogenic organisms that are introduced by nonsterile injection of drugs, contaminants, and fillers, some of which may cause local tissue reactions (e.g., vasoconstriction) that predispose to the development of infections. IDUs skin-pop most often because they are unable to gain access to a vein, but increased duration of injection drug use did not confound the relationship between skin-popping and the presence of abscesses and cellulitis. Education about safe and sterile injection techniques could help IDUs preserve access to their veins and reduce the risk of infections associated with skin-popping, but intravenous injection is associated with other risks. IDUs should be advised to avoid injecting into the groin and neck where abscesses can have severe complications.

If available, point-of-care ultrasound may be used to identify extent of abscess and possible loculations.

Skin abscess

Antibiotics increase cure rate from small skin abscesses compared with ...

IDUs who skin popped (injected subcutaneously or intramuscularly) in the 30 days before interview were more likely to have an abscess or cellulitis (23 [61%] of 38) than those who had injected only intravenously (31 [24%] of 131; OR, 4.9; 95% CI, 2.2–11.4). The prevalence increased with the frequency of skin popping ( table 1). IDUs were progressively less likely to have an abscess or cellulitis the longer they had been injecting (linear trend test, P = .02; table 1). In multiple logistic regression analysis, having an abscess or cellulitis remained significantly associated with frequency of skin-popping and duration of injection drug use, but was not associated with any other variable. When we controlled for skin-popping and years of injection drug use, the participants who licked their needles before injecting were more likely to have an abscess or cellulitis than those who did not lick their needles (unadjusted OR, 1.4; 95% CI, 0.7–2.8; adjusted OR, 1.9; 95% CI, 0.9–4.3). This effect did not reach statistical significance.

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Discussion

Methadone treatment enriched with on-site HIV medical care may reduce hospital admissions related to abscesses and cellulitis [ 8]. Prompt access to substance abuse treatment should be available to all IDUs, but a comprehensive plan is needed that includes IDUs who are not interested in drug treatment (approximately one-half of our sample) and those who will not stop injecting completely while in treatment. To our knowledge, there are no studies on the effect of decriminalized heroin on the incidence of abscesses.

If injecting along the incision, be careful not to inject into the abscess cavity, which is painful and fails to numb the skin.

Safer Injecting Practices

MRSA Pictures / Staph Infection Pictures/Graphic Images

Written by
Northeast Addition Editorial Team

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Infectious Diseases

When left untreated, collapsed veins hinder your blood circulation and raise your risk of cardiovascular problems, including stroke.

Bivariate relationships between potential risk factors and the presence of an abscess or cellulitis were examined by use of the Mantel-Haenszel χ 2 test. Independent variables associated with the dependent variable in the bivariate analyses or in previous studies or whose effects could confound those of other variables were included in logistic regression models.

Drug Use and Abscesses

Abdominal-Wall Abscess — NEJM

In general, people who inject drugs feel the effects within a few minutes. If you miss the shot, you won’t feel the effects at all.

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What To Do If You Miss A Shot

You may also be given antibiotics if the abscess is infected.

A skin abscess is a lump or swelling on your skin that contains pus. There are different types and they can appear anywhere on your body.

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