Bath Salt Thrombosis

Abstract

This report describes the treatment of a thirty-one year old chronic drug abuser who claimed to use intravenous morphine daily along with a wide array of other illegal drugs and bath salts. The unkempt patient was diagnosed with hypertension and extensive occlusive thrombosis throughout bilateral cephalic veins extending from the neck to below the elbow.Keywords: Bath salts; Thrombosis; Antecubital fossa injections; Cathinone Case ReportThirty-one year old chronic drug abuser presented to our local hospital. He claimed to use intravenous morphine daily along with a wide array of other illegal drugs such as hydromorphone, fentanyl and oxymorphone. He was diagnosed with hypertension but admitted to being non-adherent to his medication. He complained of bilateral upper arm swelling and pain which started a day after injecting bath salts on both antecubital fossae. He stated that he used bath salts in this route before without such complications. He denied any fever, chills, chest pain, shortness of breath, abdominal pain, nausea or vomiting. Physical examination revealed an unkempt man who was not in acute respiratory distress. His bilateral upper extremities were swollen, tender and erythematous. Neurologic exam was non-focal. Venous Doppler ultrasound of the upper extremities revealed extensive occlusive thromboses throughout bilateral cephalic veins extending from the neck to below the elbow. CT scan of the chest did not reveal any pulmonary embolus. He was started on anticoagulation and antibiotics for cellulitis. He was discharged a few days later after symptoms abated. He has not followed-up for his clinic appointments and INR monitoring.

NPS: Medical Consequences Associated with Their Intake

“…Deaths have been associated with a range of synthetic cathinones, including: mephedrone [87,88,90,101,102], methylone and butylone [103], ethylone [104], bupropion [82], α-PVP [95,105,106], MDPV [93,[107][108][109], and methedrone [110].…”