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. 2015 Dec 15;61(12):1840-9.
doi: 10.1093/cid/civ689. Epub 2015 Aug 12.

Emerging and Underrecognized Complications of Illicit Drug Use

Alysse G Wurcel  1 , Elisabeth A Merchant  2 , Roger P Clark  3 , David R Stone  4
Affiliations

Emerging and Underrecognized Complications of Illicit Drug Use

Alysse G Wurcel et al. Clin Infect Dis. .

Abstract

Illicit drug use can result in a wide range of medical complications. As the availability, synthesis, and popularity of illicit drugs evolve over time, new syndromes associated with their use may mimic infections. Some of these symptoms are anticipated drug effects, and others are complications of adulterants mixed with drugs or complications from the method of using drugs. Some illicit drugs are associated with rare infections, which are difficult to diagnosis with standard microbiological techniques. The goal of this review is to orient a wide range of clinicians-including general practitioners, emergency medicine providers, and infectious diseases specialists-to complications of illicit drug use that may be underrecognized. Improving awareness of infectious and noninfectious complications of illicit drug can expedite diagnosis and medical treatment of persons who use drugs and facilitate targeted harm reduction counseling to prevent future complications.

Keywords: altered mental status; illicit drug use; injection drug use; skin and soft-tissue infections; substance abuse.

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Figures

Figure 1.
Figure 1.
Tissue biopsy specimen from the shoulder of a patient with recent subcutaneous injection of tar heroin (400× photomicrograph).
Figure 2.
Figure 2.
Leg ulcerations attributed to levamisole-adulterated cocaine.
Figure 3.
Figure 3.
Rash attributed to levamisole-adulterated cocaine.
Figure 4.
Figure 4.
Computed tomographic scan of patient with pulmonary granulomatosis from cocaine adulterated with talc.
Figure 5.
Figure 5.
Magnetic resonance image shows leukoencephalopathy from inhaled heroin use.
See this image and copyright information in PMC

References

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