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Health advisory: Fatal Clostridial Infections in Injecting Drug Users
February 27, 2004 |
Since January 2004, 3 cases of fatal Clostridium infections have occurred among heroin-injecting drug users (IDU) diagnosed with necrotizing faciitis or myonecrosis in King County. In one case, C. sordellii was isolated; the clostridial species for the two other cases is not available at this time. Several clostridial species in addition to C. perfringens can cause severe systemic illness associated with wound and soft tissue infections. C. sordellii causes a distinctive, toxin-mediated illness characterized by tissue edema, myonecrosis, leukemoid reaction and sudden onset of shock.
Health care providers are requested to have increased vigilance for clostridial infection in cases of soft-tissue infection among IDUs, particularly heroin injectors. Suspected cases of clostridial wound infection should be managed aggressively with surgical debridement and antibiotic treatment. Tissue and blood cultures for clostridial species should be obtained when appropriate. Consultation with surgical and infectious disease specialists should be considered.
Health care providers and hospitals are requested to report cases of clostridial myonecrosis and/or necrotizing faciitis among IDU to Public Health at 206-296-4774.
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