       Document 0042
 DOCN  M9620042
 TI    Soft tissue abscesses associated with parenteral drug abuse:
       presentation, microbiology, and treatment.
 DT    9602
 AU    Bergstein JM; Baker EJ 4th; Aprahamian C; Schein M; Wittmann DH;
       Department of Surgery, Medical College of Wisconsin, Milwaukee; 53226,
       USA.
 SO    Am Surg. 1995 Dec;61(12):1105-8. Unique Identifier : AIDSLINE
       MED/96074177
 AB    Abscess formation at the site of drug injection is the commonest
       infectious complication in drug addicts. This study characterizes the
       clinical presentation of the condition, its current microbiology, and
       treatment outcome. All patients presenting for treatment of soft tissue
       abscesses associated with parenteral drug abuse over a 21-month period
       were studied. Sixty-six patients with 70 subcutaneous abscesses after
       injection of cocaine (85%), heroin (5%), or unreported drugs (10%) were
       identified. Only 42% were febrile (T > 37.5 degrees C), 54 percent had
       leukocytosis, and 47 percent had wound fluctuance. Wound cultures (243
       isolates in 57 patients) grew predominately anaerobes (143 isolates) and
       facultative gram-positive cocci (88 isolates). Twenty-six blood cultures
       were obtained, and five (19%) were positive, two with the same bacteria
       isolated from the wound. Of the patients tested, 29 percent were
       positive for hepatitis B surface antigen and 9 percent for HIV. Simple
       incision and drainage was effective in all cases. Classical signs and
       symptoms of infection and abscess formation may be absent in this
       patient population. Many of these patients carry other blood-borne
       infections which the health professional must guard against. Cocaine
       injection, and mixed aerobic-anaerobic infections predominated, in
       contrast to earlier reports, when narcotics and aerobes predominated.
       Simple incision and drainage is adequate treatment; antibiotics, when
       given, should cover gram-positive and anaerobic bacteria; gram-negative
       coverage is unnecessary.
 DE    *Abscess/ETIOLOGY/MICROBIOLOGY/THERAPY  Adult  Aged
       Antibiotics/THERAPEUTIC USE  *Bacterial
       Infections/ETIOLOGY/MICROBIOLOGY/THERAPY  Combined Modality Therapy
       Drainage  Female  Human  Male  Middle Age  Retrospective Studies  *Soft
       Tissue Infections/ETIOLOGY/MICROBIOLOGY/THERAPY  Substance Abuse,
       Intravenous/*COMPLICATIONS  Treatment Outcome  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

