05 Jun IV Drug Abuse and Cellulitis
Cellulitis is the medical term for a specific type of infection that occurs when bacteria gain a foothold in broken skin. While some forms of this infection produce localized or relatively minor health problems, other forms can spread in the bloodstream and trigger the onset of a variety of severe, potentially fatal health complications. IV (intravenous) drug abusers have significantly increased risks for developing cellulitis. In some cases, people who use IV drugs also have additional health problems that increase the likelihood of highly dangerous cellulitis-related complications.
All human beings have a variety of different bacteria species living on the surfaces of their skin. While some of these bacteria are essentially harmless, others can cause significant problems if they make their way through the skin’s outer layer, or travel even deeper into the body. In most cases, skin bacteria gain access by traveling through breaks or cracks in the skin’s surface. However, in older people, people who have impaired immune systems and people with diabetes, these bacteria can also cause damage in the absence of an abnormal skin opening.
Cellulitis usually occurs when the bacteria on broken or weakened skin belong to a species group called Staphylococcus bacteria, or another species group called Streptococcus bacteria. Other species capable of producing the condition include Haemophilus influenzae, Pseudomonas aeruginosa, a group of anaerobic bacteria called Eikenella, and a species found in raw meat called Erysipelothrix rusiopathiae. Apart from IV drug abuse, the US National Library of Medicine lists known risk factors for the development of cellulitis that include being bitten by a human or animal, being bitten or stung by an insect, having peeling or cracking skin between any of your toes, having diabetes-related skin ulcers, experiencing any kind of physical trauma that produces broken skin, having an unhealed surgical wound and using any medication that decreases normal immune system vitality.
In its localized form, cellulitis commonly produces symptoms that include abnormally warm skin at the site of infection, an elevated body temperature (i.e., fever), inflammation and/or redness that grows worse over time, tenderness or pain in the infected tissue, the rapid development of a rash or sore in the area of the infected tissue, and skin that develops an abnormally tight and shiny appearance. Additional symptoms of a cellulitis-related infection include unexplained fatigue, increased sweat output, achy or painful muscles, chills, uncontrolled shaking or shivering, and a general sense of physical malaise. Serious or potentially fatal complications of uncontrolled, spreading cellulitis include bone or blood infections, heart inflammation, inflammation of the membranes surrounding the brain and spinal cord, the onset of gangrene (tissue death) and a dangerous systemic condition called shock.
The Effects of IV Drug Abuse
IV drug abusers can increase their risks for developing cellulitis in several different ways. First, nonsterile needle sharing practices among users can increase the person-to-person transmission of Staphylococcus and Streptococcus bacteria, and also give those bacteria an easy way to enter into the skin’s deeper layers. In many cases, the drugs used during IV injection also increase the risks for cellulitis development by directly damaging the tissues around an injection site. In addition, long-term use of various injected drugs of abuse can lead to significant declines in normal immune system health; in turn, the compromised immune system in an IV drug user may lose some of its ability to fend off cellulitis-causing bacteria.
In people who intravenously inject cocaine or methamphetamine, a reduction in normal blood flow may also contribute to the onset of cellulitis or other types of skin infections, according to a study review published in 2004 in the British Journal of Dermatology. The authors of this review also note the heavy prevalence of preexisting bacterial contamination in street doses of heroin and other IV drugs of abuse. When injected into the body, these contaminated materials may boost the risks for cellulitis even higher.
Anywhere from roughly 20 to 65 percent of all addicts who use IV drugs have cellulitis and/or another common form of skin infection called an abscess, the authors of the review in the British Journal of Dermatology report. Compared to non-drug-using populations, IV drug users may have a greater tendency to develop forms of cellulitis that stem from unusual species of bacteria, or from multiple bacterial species. Because of the immune system depletions commonly associated with long-term intravenous injection, IV drug users may also have seriously increased risks for the development of some of the more extreme, potentially lethal consequences of an unchecked cellulitis infection. The specific risks for these advanced problems vary according to a number of different factors, including the degree of immune system dysfunction found in any given IV drug-using individual.
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