Callahan and colleagues describe a group of 30 patients seen during 5 years at San Francisco General Hospital with NSTI from illicit drug injections. This small, but remarkable, subgroup of 3560 patients with cutaneous abscesses from illicit drug injection experienced a 20% mortality. The authors, having sought clinical clues to differentiate patients with NSTI from those with simple cutaneous abscesses, concluded that a high index of suspicion and an inquisitive operative approach were necessary to avoid missing these serious infections.
Henderson VJ. Necrotizing Soft Tissue Infection Masquerading as Cutaneous Abscess Following Illicit Drug Injection—Invited Commentary. Arch Surg. 1998;133(8):819. doi:10.1001/archsurg.133.8.819