Acute Forefoot Phlegmon – A Complication of Intravenous Heroin-Addiction


  • Uwe Wollina Stadtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen
  • Torello Lotti University G. Marconi of Rome - Dermatology and Venereology, Rome
  • Georgi Tchernev Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, Sofia; Onkoderma, Policlinic for Dermatology and Dermatologic Surgery, Sofia



Phlegmon, Skin and soft tissue infection, Intravenous drug abuse, Heroine, Treatment, Forefoot


Infections of the skin and soft tissues (SSTI) are clinical entities with variable presentations, causes, and levels of clinical severity. They are frequent in emergency departments. The most common pathogen in the Western World is Staphylococcus aureus. SSTI may provide a hint to underlying pathologies such as diabetes and other states of immune compromise. Here we present a 41-year-old non-diabetic male patient with pain and swelling of the left forefoot but not any recent trauma. Microbiology identified streptococci. The medical history was positive for intravenous heroin abuse. The diagnosis of forefoot phlegm due to drug addition was confirmed. Treatment was realised by a combination of intravenous antibiosis and drainage. Intravenous drug addiction is a significant risk factor for SSTI.


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How to Cite

Wollina U, Lotti T, Tchernev G. Acute Forefoot Phlegmon – A Complication of Intravenous Heroin-Addiction. Open Access Maced J Med Sci [Internet]. 2018 Jan. 9 [cited 2022 Oct. 1];6(1):85-6. Available from:

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