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Infections in Drug Users Tahseen J. Siddiqui,  M.D
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object]
Drug Situation: Chicago  ,[object Object],[object Object],[object Object],2005 Federal Drug Seizures   Cocaine:  2,623.2 kgs.   Heroin:  24.1 kgs.   Methamphetamine:  14.2  kgs./3,181 du    Marijuana:  2,546.2 kgs.   Hashish:  3.7 kgs   MDMA:  0.3 kgs/78,901 du    Meth Lab Incidents:  931 (DEA, state, and local)
Drugs   The Methods of Adm in istration
Marijuana ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Marijuana
Cocaine  ,[object Object],[object Object],[object Object]
Crack cocaine ,[object Object]
Cocaine  Smoking Crack Cocaine
Cocaine
Heroin ,[object Object],[object Object],[object Object],[object Object]
Heroin ,[object Object]
Heroin Heroin comes in a white to brown powder or a dark tar-like substance, and is sold in a variety of packaging The most popular form of heroin is a dark tar-like substance called black tar, which is sold in small foil or cellophane packets or in small toy balloons.  The most common use of heroin is by injection (called "mainlining" or "shooting"), but in it's powder form it can be inhaled through the nose or smoked.
Black tar heroin and the paraphernalia for injecting and storing the drug   Paraphernalia for injecting heroin include hypodermic needles, small cotton balls used to strain the drug, and water and spoons or bottle caps used for "cooking" or liquefying the heroin. Paraphernalia for inhaling or smoking heroin includes razor blades, straws, rolled dollar bills, and pipes. The high from the drug usually lasts from four to six hours.
Selected street names and adverse effects of illicit drugs   ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Selected street names and adverse effects of illicit drugs
[object Object],[object Object],[object Object],[object Object],Selected street names and adverse effects of illicit drugs
[object Object],[object Object],[object Object],Selected street names and adverse effects of illicit drugs
[object Object],[object Object],[object Object],[object Object],Selected street names and adverse effects of illicit drugs
Selected street names and adverse effects of illicit drugs ,[object Object],[object Object],[object Object]
Selected street names and adverse effects of illicit drugs ,[object Object],[object Object],[object Object]
Selected street names and adverse effects of illicit drugs ,[object Object],[object Object],[object Object]
Crystal Methamphetamine ,[object Object],[object Object],[object Object],[object Object]
Epidemiology   ,[object Object],[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathogenesis   ,[object Object],[object Object],[object Object]
Role of Commensal Flora   ,[object Object],[object Object],[object Object],[object Object]
Sharing of Drug Paraphernalia   ,[object Object],[object Object],[object Object],[object Object]
Transmission through Drugs or  Drug Adulterants  and  Drug Preparation   ,[object Object],[object Object],[object Object]
Gordon R and Lowy F. N Engl J Med 2005;353:1945-1954 Organisms Responsible for Bacterial Infections in Drug Users
Skin, Soft-Tissue & Musculoskeletal  Infections ,[object Object],[object Object]
Skin, Soft-Tissue & Musculoskeletal  Infections   ,[object Object],[object Object],[object Object],[object Object]
Skin, Soft-Tissue & Musculoskeletal  Infections ,[object Object],[object Object],[object Object]
Heroin Skin, Soft-Tissue & Musculoskeletal  Infections
Heroin  Skin, Soft-Tissue & Musculoskeletal  Infections
Skin, Soft-Tissue & Musculoskeletal  Infections Soft-Tissue Abscess on the Leg of an Injection-Drug User. "Track" marks from injections extend along the calf.  Provided courtesy of Robert Gwizdala. CA-MRSA PDF MRI in an Injection-Drug User with Vertebral Osteomyelitis Involving T6–T7 (Arrow) with an Adjacent Epidural Abscess. Culture grew  Enterobacter cloacae .
Endovascular Infections   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Tricuspid Endocarditis &   Septic Pulmonary Emboli Right-sided staphylococcal endocarditis and multiple embolic pyogenic abscesses  Petechial rash due to right-sided staph endocarditis   Tricuspid valve endocarditis with  Staphylococcus aureus , and multiple septic pulmonary emboli, prominent in the right upper lobe with both solid and cavitary appearance.   Parasternal long axis view from a transthoracic echocardiogram. There is a small curvilinear vegetation on the mitral valve as indicated
Septicemia and Disseminated Infections (Other Than Endocarditis)   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Respiratory Tract Infections   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Non Infectious Pulmonary Complications ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],Cocaine Lung  Toxic  oedema  prsented as six month history of malaise and recently increasing haemoptysis         Pulmonary edema                    Pulmonary haemorrhage      Pulmonary barotrauma (Air escaping  lungs by  holding in crack smoke)          Foreign bodies in lungs        'Crack Lung' - Cough, shortness breath, fever,  Talc in the lung   Drug abuse. Injecting drugs (heroin, methamphetamine, cocaine...) that are frequently "cut" with talc will cause serious damage
Septicemia and Disseminated Infections
Clostridial infections  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pulmonary and Cardiovascular Complications of IV Drug Use   Charles E.  Cherubin  and Joseph D.  Sapira
Gordon R and Lowy F. N Engl J Med 2005;353:1945-1954 Initial Management of Bacterial  Infectious  Syndromes among Suspected Drug Users
Syphilis and Other Sexually Transmitted Diseases   ,[object Object],[object Object],[object Object]
References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Infections In Drug Users

  • 1. Infections in Drug Users Tahseen J. Siddiqui, M.D
  • 2.
  • 3.
  • 4. Drugs The Methods of Adm in istration
  • 5.
  • 6.
  • 7.
  • 8.
  • 9. Cocaine Smoking Crack Cocaine
  • 11.
  • 12.
  • 13. Heroin Heroin comes in a white to brown powder or a dark tar-like substance, and is sold in a variety of packaging The most popular form of heroin is a dark tar-like substance called black tar, which is sold in small foil or cellophane packets or in small toy balloons. The most common use of heroin is by injection (called "mainlining" or "shooting"), but in it's powder form it can be inhaled through the nose or smoked.
  • 14. Black tar heroin and the paraphernalia for injecting and storing the drug Paraphernalia for injecting heroin include hypodermic needles, small cotton balls used to strain the drug, and water and spoons or bottle caps used for "cooking" or liquefying the heroin. Paraphernalia for inhaling or smoking heroin includes razor blades, straws, rolled dollar bills, and pipes. The high from the drug usually lasts from four to six hours.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31. Gordon R and Lowy F. N Engl J Med 2005;353:1945-1954 Organisms Responsible for Bacterial Infections in Drug Users
  • 32.
  • 33.
  • 34.
  • 35. Heroin Skin, Soft-Tissue & Musculoskeletal Infections
  • 36. Heroin Skin, Soft-Tissue & Musculoskeletal Infections
  • 37. Skin, Soft-Tissue & Musculoskeletal Infections Soft-Tissue Abscess on the Leg of an Injection-Drug User. "Track" marks from injections extend along the calf. Provided courtesy of Robert Gwizdala. CA-MRSA PDF MRI in an Injection-Drug User with Vertebral Osteomyelitis Involving T6–T7 (Arrow) with an Adjacent Epidural Abscess. Culture grew Enterobacter cloacae .
  • 38.
  • 39. Tricuspid Endocarditis & Septic Pulmonary Emboli Right-sided staphylococcal endocarditis and multiple embolic pyogenic abscesses Petechial rash due to right-sided staph endocarditis Tricuspid valve endocarditis with Staphylococcus aureus , and multiple septic pulmonary emboli, prominent in the right upper lobe with both solid and cavitary appearance. Parasternal long axis view from a transthoracic echocardiogram. There is a small curvilinear vegetation on the mitral valve as indicated
  • 40.
  • 41.
  • 42.
  • 43.
  • 45.
  • 46. Pulmonary and Cardiovascular Complications of IV Drug Use Charles E. Cherubin and Joseph D. Sapira
  • 47. Gordon R and Lowy F. N Engl J Med 2005;353:1945-1954 Initial Management of Bacterial Infectious Syndromes among Suspected Drug Users
  • 48.
  • 49.

Editor's Notes

  1. Table 1. Organisms Responsible for Bacterial Infections in Drug Users.
  2. Table 2. Initial Management of Bacterial Infectious Syndromes among Suspected Drug Users.