[Enterobacter cloacae spondylodiscitis through misuse of high-dose intravenous buprenorphine].
BACKGROUND
We report a case of Enterobacter cloacae spondylodiscitis related to risk practices in intravenous drug addicts (IVDA).


METHODS
The patient, a former heroin addict, was receiving long-term, high-dose buprenorphine maintenance treatment. He had been misusing the treatment, injecting it daily for several months. The clinical course included several uncommon features that are usually found in IVDA patients: subacute infection, apyrexia, and minimal inflammatory syndrome. This infection also led to the discovery of his HIV infection.


CONCLUSIONS
Any dorsolumbar pain in IVDA patients, including those receiving regular drug maintenance treatment and especially those with HIV infection, should suggest spondylodiscitis, because of these patients' enhanced sensitivity to infection and the frequent bacteremia caused by persistent or transitory relapse involving injection (exchange of material, reuse of needles, syringes, cotton swabs, and risk of contamination through the hands or saliva).
Etchepare
F
F
Service rhumatologie Hôpital de la Pitié-Salpêtrière, Paris (75).
Coutaux
A
A
Edel
Y
Y
Bourgeois
P
P
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D002047:Buprenorphine / Q000008:administration & dosage / Q000009:adverse effects*; D015299:Discitis / Q000139:chemically induced* / Q000175:diagnosis / Q000382:microbiology; D016972:Enterobacter cloacae; D004756:Enterobacteriaceae Infections / Q000139:chemically induced* / Q000175:diagnosis; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D015819:Substance Abuse, Intravenous / Q000150:complications*
D000701:Analgesics, Opioid; D002047:Buprenorphine