title: Risk factors for skin and soft-tissue abscesses among injection drug users: a case-control study.
abstract: Skin and soft-tissue abscesses, a common problem among injection drug users (IDUs), result in serious morbidity for the patient and costly hospitalizations for incision and drainage; however, there has been little etiologic or preventive epidemiologic research on this problem. We performed a case-control study that enrolled 151 IDUs who had been given a new diagnosis of abscess requiring incision and drainage (cases) and 267 IDUs who did not have abscess or other bacterial infection during the previous year and who were stratum-matched to cases according to age, sex, and race (controls). Subcutaneous or intramuscular, instead of intravenous, injection is a major risk factor for abscess among IDUs. The injection of a cocaine and heroin mixture, or "speedball," may predispose patients to develop abscess by inducing soft-tissue ischemia. Cleaning the skin with alcohol before injection was found to have a protective effect. Neither human immunodeficiency virus nor human T-lymphotropic virus type II seropositivity was significantly associated with abscess.
authors.affiliation: Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA 94143-0884, USA. murphy@itsa.ucsf.edu
authors.forename: E L
authors.initials: EL
authors.lastname: Murphy
authors.forename: D
authors.initials: D
authors.lastname: DeVita
authors.forename: H
authors.initials: H
authors.lastname: Liu
authors.forename: E
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: P
authors.initials: P
authors.lastname: Leung
authors.forename: D H
authors.initials: DH
authors.lastname: Ciccarone
authors.forename: B R
authors.initials: BR
authors.lastname: Edlin
mesh_terms: D000038:Abscess / Q000209:etiology*; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017192:Skin Diseases, Bacterial / Q000209:etiology*; D018461:Soft Tissue Infections / Q000209:etiology* / Q000382:microbiology; D015819:Substance Abuse, Intravenous / Q000150:complications*