Acute Forefoot Phlegmon – A Complication of Intravenous Heroin-Addiction

Authors

  • 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

DOI:

https://doi.org/10.3889/oamjms.2018.050

Keywords:

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

Abstract

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.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Linder KE, Nicolau DP, Nailor MD. Epidemiology, treatment, and economics of patients presenting to the emergency department for skin and soft tissue infections. Hosp Pract (1995). 2017; 45:9-15. https://doi.org/10.1080/21548331.2017.1279519 PMid:28055287

Esposito S, Noviello S, Leone S. Epidemiology and microbiology of skin and soft tissue infections. Curr Opin Infect Dis. 2016; 29:109-15. https://doi.org/10.1097/QCO.0000000000000239 PMid:26779772

Lipsky BA, Silverman MH, Joseph WS. A proposed new classification of skin and soft tissue infections modelled on the subset of a diabetic foot infection. Open Forum Infect Dis. 2016; 4:ofw255. https://doi.org/10.1093/ofid/ofw255

Miller LG, Daum RS, Creech CB, Young D, Downing MD, Eells SJ, Pettibone S, Hoagland RJ, Chambers HF; DMID 07-0051 Team. Clindamycin versus trimethoprim-sulfamethoxazole for uncomplicated skin infections. N Engl J Med. 2015; 372:1093-103. https://doi.org/10.1056/NEJMoa1403789 PMid:25785967 PMCid:PMC4547538

Nambiar D, Stoové M, Dietze P. Frequent emergency department presentations among people who inject drugs: A record linkage study. Int J Drug Policy. 2017; 44:115-20. https://doi.org/10.1016/j.drugpo.2017.03.010 PMid:28511107

Ebright JR, Pieper B. Skin and soft tissue infections in injection drug users. Infect Dis Clin North Am. 2002; 16:697-712. https://doi.org/10.1016/S0891-5520(02)00017-X

MacDonald E, Arnesen TM, Brantsaeter AB, Gerlyng P, Grepp M, Hansen BÅ, Jonsrud K, Lundgren B, Mellegård H, Møller-Stray J, Rønning K, Vestrheim DF, Vold L. Outbreak of wound botulism in people who inject drugs, Norway, October to November 2013. Euro Surveill. 2013; 18:20630. https://doi.org/10.2807/1560-7917.ES2013.18.45.20630 PMid:24229788

Palmateer NE, Hope VD, Roy K, Marongiu A, White JM, Grant KA, Ramsay CN, Goldberg DJ, Ncube F. Infections with spore-forming bacteria in persons who inject drugs, 2000-2009. Emerg Infect Dis. 2013; 19:29-34. https://doi.org/10.3201/eid1901.120044 PMid:23260795 PMCid:PMC3557973

Schroeter M, Alpers K, Van Treeck U, Frank C, Rosenkoetter N, Schaumann R. Outbreak of wound botulism in injecting drug users. Epidemiol Infect. 2009; 137:1602-8. https://doi.org/10.1017/S0950268809002544 PMid:19351433

Published

2018-01-09

How to Cite

1.
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 2021 Apr. 12];6(1):85-6. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2018.050

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 10 > >>