Surgical infections in drug addicts.

Abstract

AbstractInfectious complications are responsible for a majority of the medical and surgical hospital admissions and 15% of the deaths of drug addicts. The most common and serious complication is endocarditis, mostly of the right heart, caused by Staphylococci and/or gram‐negative rods. If the endocarditis is caused by the latter group of organisms, early operative intervention with excision of the tricuspid and/or replacement of the mitral and aortic valves is frequently necessary because of poor response to antibiotic treatment. Other complications of generalized sepsis are septic pulmonary emboli, which frequently gives rise to pulmonary abscesses, and splenic abscesses. Infections of the vascular system occur as either suppurative thrombophlebitis or mycotic aneurysms. Soft tissue infections in the form of subcutaneous abscesses, cellulitis, myositis, and necrotizing fasciitis are caused by a mixed flora consisting of gram‐positive and gram‐negative aerobes and anaerobes. The majority of patients with tetanus seen in large cities are drug addicts. Infections of the skeletal system are typically caused bySerratia marcescens orPseudomonas, and present as septic arthritis of the sternoclavicular or sacroiliac joints or osteomyelitis of the spine originating from a disc space infection.