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Shooter's Abscess

2/4/2021

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Happy Friday! Abscesses--these are an everyday occurrence, we’re either performing an I&D or seeing a patient for their 2-3 day follow-up. While regular abscesses are second nature to us, today we will be talking about a shooters abscess which are approached and treated a bit differently
 
I had 2 cases of these. This a summary of HippoEd’s UC rap June 2020 podcast chapter titled: “Shooter’s abscess." 

All my blogs are free but if you want access to all episodes of UC rap by HippoEd, use my link: here for $25 off. ​I do get a small amount of money if you use my link which allows me to continue to do these :)

What is a shooter’s abscess?
 IV drug users are at higher risk for an abscess due to introduction of bacteria from a dirty needle and/or an inflammatory reaction to the drug substance
 
Signs and symptoms will be similar to a non-shooters abscess with erythema, warmth, tenderness and fluctuance, however tend to be larger and deeper 
 
Before you perform an I&D:
  • consider obtaining an x-ray to rule out a retained foreign bodies (needles)—keep yourself and the patient safe. Do not go probing with fingers!
  • Often these are large/deep abscesses (drainage of >200 cc's) so prep appropriately—consider suction or prior to incision you can aspirate with 18 gauge needle
  • Follow up within 24-48 hours 
 
Which bacteria are present? 
  • These are usually polymicrobial: strep, MRSA, but also consider presence of anaerobes due to patients licking needles prior to injection
 
Wound culture? Start antibiotics or not?
  • Wound culture and antibiotics are usually indicated
  • Consider single drug choices: Clindamycin, doxycycline, and TMP-SMX
 
Don’t forget to: perform a full neuro exam
 
Should I treat this abscess in UC?
  • Most will be able to be drained in UC
  • Consider transfer if 
    • Signs of systemic infection—fever, tachycardia, hypotension
    • suspect necrotizing fasciitis
    • Neuro abnormalities

See you all next week......wondering what I'll see this upcoming weekend which may inspire me with a topic haha!
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    Melody, PA-C writes a weekly blog on HippoEd's Urgent Care Rap Podcast or Bootcamp. Stay tuned next week

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  • Home
  • MEDICINE
    • Dermatology Rotation
    • Advice from New Grads
    • Family Medicine Rotation
    • Global Health Rotation
    • Pediatrics Rotation
    • Stethoscopes & Yoga...and Public Health
    • Emergency Medicine Rotation
    • Medicine, Finances, Loans
    • Surgery Rotation
    • How I passed the PANCE
    • Anatomy Study Tips
    • From Student to Clinician
    • Rotations-The Logistics
  • Lifestyle
    • Completing 100 miles
    • Running 100 miles
    • Mindfullness Program
    • #healthyinmedicine
  • Medical Spanish
    • Lesson 1: Introductions
    • Lesson 2: Basic Anatomy
    • Lesson 3: Medical Specialties
    • Lesson 4: Skeletal System Anatomy
    • Lesson 5: Describing Pain
    • Lesson 6: Medications
    • Lesson 7: Medication-History, Routes, & SE
    • Lesson 8: Medication Classes
    • Lesson 9: COVID-19 symptoms
    • Lesson 10: Preventing COVID-19
    • Lesson 11: Cranial nerves
    • Lesson 12: Diagnostic Tests
    • Lesson 13: History of Present Illness (HPI)
    • Lesson 14: Dermatology
  • Urgent Care lessons
    • Introduction
    • Charting
    • Sports Physical
    • Skin Infections & Antibiotics
    • Eye Chief Complaints
    • Wound/Laceration repairs
    • Approach to Trauma & Head Injuries
    • Approach to Trauma: Neck & Spine injuries
    • Urinary Tract Infecto\\ions
    • Telemedicine Tips
    • Approach to Fractures
    • Medica Legal Lessons: Headaches
    • COVID19 Triage
    • Shooter's Abscess
    • Pediatric Burns
  • Contact
  • About