Abscesses – A Major Update

Identification, Treatment and Prevention

Abscesses are something most of us have encountered before and they can be everything from hardly noticeable, to extremely painful. Medical care can be hard to come by for many of us around the world who inject drugs and so some people resort to treating themselves, for reasons of cost, access, stigma or fear. This can lead to some serious complications as the toxicity of an abscess can vary considerably. Here are a few things to remember when it comes to getting to grips with an abscess -and whether you can really treat it yourself.  Yes, you may think you know what to do if you have an abscess, but there is new guidance in terms of treating them these days, to ‘pack or not to pack’ , antibiotics everytime or just some of the time? Yes, this is a big article and has had a major update, and we will edit it down in the coming weeks, but for now here is all the information we have collected to help you make the most important decision -when to get help. Yes, it is worth reading the whole thing if you are concerned about abscesses, or at least read the summary!

A fairly typical large abscess on a heroin user who seemed to have skin popped heroin.

A fairly typical large sized infected abscess on a heroin user who is said to have skin popped heroin recently.

 

here is one where it was recommended to just cut and drain, and not necessarily dispense antibiotics

This is a pic of an infected abscess, but one where it was only recommended to just cut and drain, and not necessarily dispense antibiotics.

A Sterile Abscess is caused by injecting either an irritating or insoluble substance into a vein – and if some of the cut in your drugs are insoluble, a sterile abscess is sometimes formed. It is basically a milder form of the same process of an infected abscess, caused not by germs this time but by nonliving irritants such as drugs. If an injected drug is not absorbed, it stays where it was injected and may cause enough irritation to generate a sterile abscess—sterile because there is no infection involved. Sterile abscesses are quite likely to turn into hard, solid lumps as they scar, rather than remaining pockets of pus. It will not usually show signs of heat although there may be a touch of redness and it can feel like a solid nodule under the skin and isn’t likely to be sore. Soreness will depend on the volume of substance under the skin. Don’t try to squeeze or poke it as it will usually go away in its own time and squeezing it could induce an infection.

A Septic or  an Infected Abscess can occur anywhere in the body. In the injecting community in which we are referring to here, these can be caused by either using non-sterile injecting equipment or by bacteria from your skin entering under the skin via the injecting process. An infected abscess will soon come up as a swollen lump on or near the injection site. Appearing inflamed and red, it feels hot to the touch and soon becomes very painful. The abscess may come to a ‘head’ or ‘point’ and be filled with pus. Sometimes a deep abscess will eat a small channel (sinus) to the surface and begin leaking pus. It can be tempting to squeeze or burst it now – but DON’T! This will only spread the infection, driving it deeper and wider, and it could head for the bloodstream making you very ill by giving you blood poisoning which can be fatal!

For a much more in depth look, click here for the rest of the article which covers topics such as Antibiotics -Yes or No?, Prevention, Treatment, Home Treatment, click here.

For information concerning users of steroids and performance enhancing drugs, and abscess, click here.

Staph Infection – a very interesting run down on an injectors worst enemy

bug for today: staphylococcus aureus

Staphylococcus aureus (Image by estherase via Flickr)

I found a very interesting article on Staphylococcus infection. There is floating bits of discussion about it in the harm reduction scene and many people (especially injectors) have heard of it. It is interesting for drug injectors as its an infection that turns up when we get abscesses, or endocarditis (infection in heart valve), or osteomyelitis (infection in bone) cellulitis (in skin) and blood poisoning. Here is an article that, in layman’s language, talks about staph, its life on the body and how it gets to play a role in so many infections. Definitely useful information to have if you either inject drugs or you work with injectors and/or harm reduction. Here’s an excerpt of the article and a link to the page…

“….Anyone can develop a Staph infection, although certain groups of people are at greater risk, including newborn infants, breast feeding women, and people with chronic conditions such as diabetes, cancer, vascular disease, and lung disease. Injecting drug users, those with skin injuries or disorders, intravenous catheters, surgical incisions, and those with a weakened immune system all have an increased risk of developing Staph infections.

Symptoms and Signs

Staphylococcal disease of the skin usually results in a localized collection of pus, known as an abscess, boil, or furuncle. The affected area may be red, swollen, and painful. Drainage or pus is common.

Skin infections are the most common type of disease produced by Staphylococcus. Staph infections of the skin can progress to impetigo (a crusting of the skin) or cellulitis (inflammation of the connective tissue under the skin, leading to swelling and redness of the area). In rare cases, a serious complication known as scalded skin syndrome can develop. In breastfeeding women, Staph can result in mastitis (inflammation of the breast) or in abscess of the breast.

Staphylococcal pneumonia predominantly affects people with underlying lung disease and can lead to abscess formation within the lungs.

Infection of the heart valves (endocarditis) can lead to heart failure. Spread of Staphylococci to the bones can result in severe inflammation of the bones known as osteomyelitis.

When Staph bacteria are present in the blood, a condition known as Staphylococcal sepsis (widespread infection of the bloodstream) or Staphylococcal bacteremia exists. Spread of the organisms to the bloodstream is known as bacteremia or sepsis. When Staph is in the blood (bacteremia or sepsis) it can cause high fevers, chills, and low blood pressure.Staphylococcal sepsis is a leading cause of shock and circulatory collapse, leading to death, in people with severe burns over large areas of the body. When untreated, Staph aureus sepsis carries a mortality (death) rate of over 80 percent.

Toxic shock syndrome is an illness caused by toxins secreted by Staph aureus bacteria growing under conditions in which there is little or no oxygen.

Staphylococcal infections should be contagious and can be transmitted from person to person. Pus from infected wounds may contain the bacteria, proper hygiene and handwashing is required when caring for Staph-infected wounds.

Are Staph infections contagious?

Staph skin infections are contagious. They can spread by:

* Skin to skin contact with infected person

* Sharing razors, towels, clothes, bed linens, sport equipment (athletes!), toys

* Walking barefoot or sitting around swimming pools

* Contact with infected pets

* Auto-infection by nose picking and skin scratching

* Sneezing – when droplets from the nose of infected person (or staph carrier) fall on an injured skin of another person

To read the rest of what is a useful article – and of which an excerpt, click here.

Abscesses; Sterile or Infected?

An abscess on the skin, showing the redness an...

An abscess on the skin, showing the redness, swelling & characteristic blackish ring surrounding the head.

Identification, Treatment and Prevention

Abscesses are something most of us have encountered before and they can be excruciatingly painful. Sympathetic medical care can be hard to come by for many of us who use drugs and so some people resort to treating themselves. This can lead to some serious complications as the toxicity of an abscess can vary considerably. Here are a few things to remember when it comes to getting to grips with an abscess….

Abscesses present themselves as raised lumps on the skin and can either be sterile or infected.

Many drug injectors will have an abcess at some stage in their inecting careers but it is by no means a certainty – they can be prevented.

A sterile abscess is caused by injecting either an irritating or insoluble substance into a vein – particularly so if you miss the vein and your drugs leak into the muscle / skin area. It may develop slowly and not usually show signs of heat although there may be a touch of redness and it can feel like a solid nodule under the skin but generally will not be sore to the touch. Don’t try to squeeze or poke it as it will usually go away in its own time ( although this can take quite a while and it may look pretty ugly.) See ‘What’s in an Abscess’ for what happens if you decide to squeeze…

An infected abscess, on the other hand, is a different story. Caused by either using non-sterile injecting equipment or by bacteria from your skin entering under the skin via the injecting process, an infected abscess will soon come up as a swollen lump on or near the injection site. Appearing inflamed and red, it feels hot to the touch and soon becomes very painful. The abscess may come to a ‘head’ or ‘point’ and be filled with pus. It can be tempting to squeeze or burst it now – but DON’T! This will only spread the infection, driving it deeper and wider, and it could head for the bloodstream giving you blood poisoning.

If you want to know what inside your abscess – here’s a little insight – For the remaining article, which appeared in Black Poppy issue 2, click here.

%d bloggers like this: