Intravenous drug use

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Background

  • Complications of intravenous drug use span all organ systems (in addition to the Toxidromes related to the specific chemical used).

Complications by System

Cardiovascular

Soft Tissue Infections

Pulmonary

  • PE
  • Talcosis (trash lung)
  • Pulmonary hypertension
  • Pneumothorax (usually due to injecting in neck vessels)

Skeletal

Central Nervous System

  • Endocarditis
  • SAH - especially with sympathomimetics such as methamphetamine and cocaine
  • Brain abscess
  • Subdural empyema
  • Botulism - especially with "skin popping" of black tar heroine
  • CVA

Ocular

  • Fungal endophthalmitis
  • Amaurosis fugax

Hematogenous

Infectious Disease

  • Cotton fever
    • Occurs when cotton is used to filter drugs like heroin and due to the exotoxin from Pantoea agglomerans which colonizes cotton plants[2]
  • HIV related
  • TB

References

  1. http://www.harmreductionjournal.com/content/6/1/30
  2. D. W. Harrison et al."'Cotton Fever': a benign febrile syndrome in intravenous drug abusers", Journal of Emergency Medicine, March–April 1990, pp. 135-139