[Extensive bilateral lower leg muscle necrosis after nasal application of heroin. Macroscopic and histologic findings in a 23-year-old man].
Rhabdomyolysis is one of the less known complications of heroin abuse. A case of lower leg muscle necrosis after nasal application of heroin is reported with repeated resection of the necrotic muscles. Superinfection with a methicillin-resistant Staphylococcus aureus (MRSA) strain was present. After 4 weeks, bilateral amputation could not be avoided. We regard a direct toxic effect of the heroin as the most probable mechanism of the muscular damage, with possible influence of the reduced oxygen delivery due to central respiratory and circulatory depression.
Institut für Pathologie, Singen, Akademisches Lehrkrankenhaus der Universität Freiburg.
U
U
Oehler
I
I
Sinicina
B
B
Helpap
D000281:Administration, Intranasal; D000328:Adult; D000671:Amputation, Surgical; D003932:Heroin / Q000008:administration & dosage / Q000633:toxicity*; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D007866:Leg; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology*; D009336:Necrosis; D010100:Oxygen / Q000097:blood; D012119:Respiration
D003932:Heroin; D010100:Oxygen