Fatal cutaneous anthrax in a heroin user

AbstractBackground and objective:Cutaneous anthrax usually has a mortality rate of less than 1 per cent. However, since December 2009 there have been more than 13 deaths in the UK due to anthrax-contaminated heroin. We therefore wish to raise clinical awareness of this treatable disease.Case report:We describe the case of a heroin user with an equivocal presentation of cellulitis in the neck. Within 36 hours, this led to death due to cutaneous anthrax.Conclusion:Whilst cutaneous anthrax remains rare, this case report aims to raise awareness of the fact that the symptoms and signs of this condition in intravenous drug users may not always fit the typical picture.

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Mortality and Attrition Rates within the First Year of Antiretroviral Therapy Initiation among People Living with HIV in Guangxi, China: An Observational Cohort Study

BioMed Research International ◽

10.1155/2021/6657112 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Jinhui Zhu ◽

Mohammed Adnan Yousuf ◽

Wenmin Yang ◽

Qiuying Zhu ◽

Zhiyong Shen ◽

...

Keyword(s):

Cohort Study ◽

Mortality Rate ◽

Drug Users ◽

Observational Cohort Study ◽

First Year ◽

Intravenous Drug Users ◽

First Line ◽

Attrition Rates ◽

Art Initiation ◽

Observational Cohort

Objective. To assess the mortality and attrition rates within the first year of antiretroviral therapy (ART) initiation among people living with human immunodeficiency virus (PLHIV) in rural Guangxi, China. Design. Observational cohort study. Setting. The core treatment indicators and data were collected with standard and essential procedures as per the Free ART Manual guidelines across all the rural health care centers of Guangxi. Participants. 58,115 PLHIV who were under ART were included in the study. Interventions. The data collected included sociodemographic characteristics that consist of age, sex, marital status, route of HIV transmission, CD4 cell count before ART, initial ART regimen, level of ART site, and year of ART initiation. Primary and Secondary Outcome Measures. Mortality and attrition rate following ART initiation. Results. The average mortality rate was 5.94 deaths, and 17.52 attritions per 100 person-years within the first year of ART initiation among PLHIV. The mortality rate was higher among intravenous drug users (Adjusted Hazard Ratio (AHR) 1.27, 95% Confidence Interval (CI) 1.14-1.43), prefecture as a level of ART site (AHR 1.14, 95% CI 1.02-1.28), and county as the level of ART site (AHR 2.12, 95% CI 1.90-2.37). Attrition was higher among intravenous drug users (AHR 1.87, 95% CI 1.75-2.00), the first-line ART containing AZT (AHR 1.09, 95% CI 1.03-1.16), and first-line ART containing LVP/r (AHR 1.34, 95% CI 1.23-1.46). Conclusion. The mortality and attrition rates were both at the highest level in the first year of post-ART; continued improvement in the quality of HIV treatment and care is needed.

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Massive hemoptysis in intravenous drug users: Case report and review of literature

Annals of Thoracic Medicine ◽

10.4103/1817-1737.30363 ◽

2007 ◽

Vol 2 (1) ◽

pp. 36 ◽

Cited By ~ 2

Author(s):

V Aiyappan ◽

M Muthiah

Keyword(s):

Case Report ◽

Drug Users ◽

Intravenous Drug ◽

Massive Hemoptysis ◽

Intravenous Drug Users ◽

Review Of Literature

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Community-acquired methicillin-resistant Staphylococcus aureus pyomyositis in an intravenous drug user

Journal of Medical Microbiology ◽

10.1099/jmm.0.46271-0 ◽

2006 ◽

Vol 55 (1) ◽

pp. 123-125 ◽

Cited By ~ 21

Author(s):

A. Fowler ◽

A. Mackay

Keyword(s):

Staphylococcus Aureus ◽

Drug Users ◽

Methicillin Resistant Staphylococcus Aureus ◽

Intravenous Drug User ◽

Intravenous Drug ◽

Intravenous Drug Users ◽

Striated Muscles ◽

Methicillin Resistant ◽

The Uk ◽

The Tropics

Pyomyositis is a disease of abscess formation deep within large striated muscles. Outside of the tropics it is a rare disease which occurs mainly in certain patient populations such as the immunosuppressed or intravenous drug users (IDUs). A case of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) pyomyositis in an IDU is described. The incidence of both CA-MRSA and pyomyositis is currently increasing. To the authors' knowledge this is the first reported case of CA-MRSA pyomyositis in the UK. Cases of CA-MRSA pyomyositis are likely to increase and it may be necessary to empirically treat certain patients with glycopeptides.

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