A review of drug addict abscesses.

1) Abscess due to subcutaneous injection of heroin (skin-popping) are very common in inner city Dublin hospitals. (2) The most common sites are the antecubital fossa and deltoid regions of the arms and the buttocks. (3) The most common organism in this series of abscesses is staph aureus. One third of all abscesses had multiple organisms. In 90% of abscesses with multiple organisms a Streptococcus is present. (4) Unexpectedly two cases of strep pneumoniae abscesses were recorded. This may be a manifestation of (a) spread via dirty needles or (b) immune deficiency in drug addicts. (5) All the organisms grown were susceptible to standard antibiotics, despite reports that in other populations of drug abusers, methicillin resistant staph aureus exist. (6) The recommended treatment for these abscesses is (a) incision and drainage with (b) antibiotics in severely ill patients and those with accompanying cellulitis.