Journal Article

Necrotizing Fasciitis Associated with Injection Drug Use

James L. Chen, Kathleen E. Fullerton and Neil M. Flynn

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 1, pages 6-15
Published in print July 2001 | ISSN: 1058-4838
Published online July 2001 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/320874
Necrotizing Fasciitis Associated with Injection Drug Use

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We studied cases of necrotizing fasciitis among injection drug users (IDUs) and non-IDUs who presented at the University of California Davis Medical Center from 1984 through 1999. Of 107 patients, 59 (55%) were IDUs and 48 (45%) non-IDUs. Among IDUs, 32 (54%) recently injected at the site of infection, and 17 patients (29%) presented with an abscess. Among non-IDUs, 17 (35%) reported a recent insect bite and 9 (19%) reported a wound or abrasion at the site of infection. Overall, seventy cases (65%) had ⩾3 debridements, and 31 patients (29%) had >5% of their total body surface area debrided. Of all patients with necrotizing fasciitis, 16 (15%) did not survive. Among the 59 IDUs, 6 (10%) did not survive, while among non-IDUs, 10 (21%) did not survive. Our results indicate the need for a high index of suspicion for necrotizing fasciitis among patients presenting with cellulitis, a recent insect bite, wound, or recent injection drug use. Preventive interventions for necrotizing fasciitis among IDUs should include street-based education and treatment for abscesses and cellulitis.

Journal Article.  4210 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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