Chest Swelling and Fever in an Intravenous Drug User

This case report describes a sternoclavicular infection in an IV drug user. The history and physical exam suggested an abscess. In the emergency department (ED) the patient refused incision and drainage but did consent to simple needle aspiration. Subsequent culture of the aspirate revealed Pseudomo...

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Bibliographic Details
Main Authors: Grijalva, Ray A, Ritter, Michael, Langdorf, Mark I.
Format: Article
Language:English
Published: eScholarship Publishing, University of California 2008-05-01
Series:Western Journal of Emergency Medicine
Subjects:
Online Access:http://escholarship.org/uc/item/1cj4g13t
Description
Summary:This case report describes a sternoclavicular infection in an IV drug user. The history and physical exam suggested an abscess. In the emergency department (ED) the patient refused incision and drainage but did consent to simple needle aspiration. Subsequent culture of the aspirate revealed Pseudomonas aeruginosa. He was admitted for IV antibiotics. After admission, a bone scan suggested the presence of osteomyelitis. The patient refused operative débridement, but ultimately did consent to bedside incision and drainage. By day five, the fever had resolved and the patient signed out AMA. He was given a prescription for Ciprofloxacin. The patient had an unscheduled follow up in the ED five months later for an unrelated heroin overdose. Physical examination demonstrated complete resolution of the infection.
ISSN:1936-900X
1936-9018