A mimic of soft tissue infection: intra-arterial injection drug use producing hand swelling and digital ischemia

作     者：Sean D.Foster Michael S.Lyons Christopher M.Runyan Edward J.Otten 

作者机构：Department of Emergency Medicine University of Cincinnati Department of Plastic Reconstructive & Hand Surgery University of Cincinnati 

出 版 物：《World Journal of Emergency Medicine》 (世界急诊医学杂志（英文）)

年 卷 期：2015年第6卷第3期

页      面：233-236页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 100205[医学-精神病与精神卫生学] 10[医学] 

主　　题：Intra-arterial injection Opioid abuse Injection drug use Digital ischemia 

摘      要：BACKGROUND: Inadvertent intra-arterial injection of illicit substances is a known complication of injection drug use and can lead to severe complications, including infection, ischemia and compartment syndrome. Identifying complications of intra-arterial injection can be difficult, as clinical manifestations overlap with other more common conditions such as cellulitis and soft tissue infection, and a history of injection drug use is frequently not ***: A 37-year-old male patient presented with 24 hours of right hand pain, erythema and swelling. Despite classic track marks, he denied a history of injection drug use, and vascular insults were not initially considered. After failing to respond to three days of aggressive treatment for suspected deep-space infection, an arteriogram demonstrated findings consistent with digital ischemia of embolic ***: As a result of the delay in diagnosis, the lesion was not amenable to reperfusion and the patient required amputation of the distal ***: Practitioners should be alert to the possibility of intra-arterial injection and resulting complications when evaluating unusual extremity infections or unexplained ischemic symptoms, even in the absence of a definite history of injection drug use.