Neck abscess secondary to pocket shot intravenous drug abuse

Sahu, Kamal Kant; Tsitsilianos, Nicholas; Mishra, Ajay Kumar; Suramaethakul, Nuttanun; Abraham, George M.

doi:10.1136/bcr-2019-234033

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…6−8 Drug abusers are exposed to variety of complications related to cardiovascular and pulmonary system. 9,10 An interesting case of spontaneous pneumopericardium secondary to cannabinoid hyperemesis syndrome was reported by Hansen et al 11…”

Section: Discussionmentioning

confidence: 97%

A rare case of Pneumopericardium secondary to COVID-19

2020

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Coronavirus disease 2019 (COVID-19) has posed an unparalleled challenge to the medical communities and patients worldwide. This is the third coronavirus pandemic of the decade and worst so far in terms of the number of patients affected and related deaths. Although COVID-19 is a systemic illness, the respiratory system is obvious to be involved first, and takes most of the brunt of SARS-CoV-2 infection. Common upper and lower respiratory presentations could be sore throat, consolidation, ground glass opacities, and acute respiratory distress syndrome in severe cases. Pneumothorax, pneumomediastinum are uncommon clinical findings in association with COVID-19. We hereby report a rare case of spontaneous pneumomediastinum with a synchronous pneumopericardium.

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Section: Discussionmentioning

confidence: 97%

A rare case of Pneumopericardium secondary to COVID-19

2020

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“…However, he suffered from a life-threatening infection. On the contrary, in another case report of a neck abscess secondary to pocket shot intravenous drug abuse, only concomitant overlying cellulitis was referred apart from the localized abscess [ 4 ]. Nevertheless, in a literature review, central venous injections in the neck have been related to numerous localized and systemic complications.…”

Section: Discussionmentioning

confidence: 99%

“…IVDAs most frequently use accessible locations, such as veins in the upper and lower extremities, for injecting illicit drugs [ 4 ]. However, as a result of repeated injections, they experience sclerosing of the peripheral veins, and then, they frequently try to inject substances into the deep veins of the neck or the groin.…”

Section: Introductionmentioning

confidence: 99%

Neck Abscess Due to Pocket Shot: Is It Just the Tip of the Iceberg?

Kollia,

Voukelatou,

Kyvetos

et al. 2023

Cureus

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A 45-year-old Caucasian male presented to the emergency department for pain and swelling on the left side of his neck for the past 10 days. His medical history revealed that he was an intravenous (IV) drug abuser. Physical examination demonstrated a 5×5 cm red, swollen bump with a positive fluctuation on the left supraclavicular area concerning for an abscess. Fluid aspiration from the abscess was performed, and three sets of blood cultures were obtained, which later all came back positive for methicillin-resistant Staphylococcus aureus (MRSA). His initial blood tests revealed elevated levels of platelets, leukocytes, and Creactive protein (CRP) and anemia. The computed tomography (CT) scan showed an enlarged pectoralis major with the presence of air. The retrosternal, infraclavicular, and supraclavicular regions also contained air. The clinical diagnosis was therefore supported by the laboratory results and imaging. Additionally, transthoracic echocardiography showed no vegetations, and transesophageal echocardiography was scheduled. Antibacterial treatment was initiated empirically from the emergency room with meropenem and vancomycin, planned for four weeks. Repeat cultures were obtained for the following three days, which were all negative. However, the patient left the hospital against medical advice and did not complete his antibiotic treatment. The risk of a peripherally inserted central catheter (PICC) line being misused for illegal narcotics was considered too high; hence, it was not recommended for continued IV antibiotic therapy at home.Those with a history of intravenous drug use, after using the most accessible injection sites, oftentimes resort to finding alternative and potentially more dangerous injection sites. The major veins of the neck, such as the jugular, subclavian, or brachiocephalic veins, are commonly used. This technique is referred to as a "pocket shot" by intravenous drug abusers (IVDAs). Apart from the apparent abscess, clinicians should oversee for other complications including underlying pus collections, pneumothorax, mediastinitis, osteomyelitis, and hemothorax.

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“…Persons who inject drugs (PWID) intravenously normally aim to inject a vein using a hypodermic needle and syringe 1 . When they miss the vein (missed hit) it may lead to skin and soft tissue injuries (SSTIs), cellulitis and/or abscess formation in varied anatomical sites [2][3][4][5][6][7][8][9][10][11] . An abscess contains a collection of pus in the dermis or sub-dermis and is characterised by pain, tenderness, redness, inflammation and infection 12 .…”

Section: Introductionmentioning

confidence: 99%

Self-treatment of abscesses by persons who inject intravenous drugs: a community-based quality improvement inquiry

Kuhnke¹,

Malik²,

Maxwell³

et al. 2023

wcet

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Objective This study had two objectives. First, to understand and then describe the experiences of persons who inject drugs (PWID) and who use self-care treatment(s) to deal with resulting skin and tissue abscesses. Next, to understand and describe their journeys to and experiences with formal healthcare service provision.Methods Semi-structured interviews were conducted with ten adults who have experience with abscesses, engage in self-care treatment(s), and utilise formal healthcare services in Nova Scotia, Canada. ResultsParticipants lived with abscesses and utilised various self-treatment strategies, including support from friends. Participants engaged in progressive self-care treatment(s) as the abscesses worsened. They reluctantly made use of formal healthcare services. Finally, participants discussed the importance of education. Moreover, they shared their thoughts in terms of how service provision could be improved.Conclusions Participants described their lives, including their journeys to intravenous drug use. They also described the self-care treatments they used to heal resulting abscesses. They used these self-care treatments because of a reluctance to utilise formal healthcare services. From a quality improvement perspective, participants outlined suggestions for: 1) expanding hours of service at the community wound care clinic and the centre; 2) permitting pharmacists to include prescribing topical and oral antibiotics; 3) promoting abscess prevention education for clients and healthcare providers; and 4) promising practices for the provision of respectful care during emergency care visits.Keywords abscesses, self-care treatment, persons who inject drugs, quality improvement For referencing Kuhnke JL et al. Self-treatment of abscesses by persons who inject intravenous drugs: a community-based quality improvement inquiry.

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Neck abscess secondary to pocket shot intravenous drug abuse

Cited by 5 publications

References 10 publications

A rare case of Pneumopericardium secondary to COVID-19

A rare case of Pneumopericardium secondary to COVID-19

Neck Abscess Due to Pocket Shot: Is It Just the Tip of the Iceberg?

Self-treatment of abscesses by persons who inject intravenous drugs: a community-based quality improvement inquiry

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