Abstract
To the Editor.— A 34-year-old former heroin addict was hospitalized with a three-day history of nosebleeds and swelling of the right arm after injecting 30 mL of Donnagel (ingredients include kaolin, pectin, opium, and belladonna alkaloids) intravenously. On admission, he had a temperature of 40 °C, pulse rate of 110 beats per minute, respiratory rate of 22/min, and blood pressure of 140/70 mm Hg. There was fresh blood in the nasal cavities. Initial laboratory data included the following values: WBC count of 6,100/cu mm with normal differential; hemoglobin, 14.6 g/dL; hematocrit, 43.2%; prothrombin time, 22 seconds; partial thromboplastin time, 120 seconds; fibrinogen, 35 mg/ dL; and platelet count, 60,000/cu mm. Factor VIII level was 77% and fibrin degradation products were 40 μg/mL. Microscopic hematuria and occult blood in stools were present. Cultures of blood, urine, and an aspirate from the swollen arm were negative. The patient was treated with 4
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