An unusual case of an extensive post-injection retroperitoneal abscess in an intravenous drug user

Area of Science:

• Medicine
• Infectious Diseases
• Radiology

Background:

• Retroperitoneal abscesses are uncommon intra-abdominal infections with potentially severe outcomes.
• Non-specific symptoms and insidious presentation can lead to delayed diagnosis and increased morbidity.
• Intravenous drug use is a risk factor for various infections, including those in deep tissue planes.

Observation:

• A 32-year-old individual with a history of intravenous drug use presented with high-grade fever, persistent hiccups, and back pain.
• Clinical examination and subsequent imaging revealed a significant retroperitoneal abscess.
• The abscess formation was linked to a recent intravenous injection in the left femoral vein.

Findings:

• The case illustrates a direct correlation between intravenous injection site and the development of a deep-seated retroperitoneal infection.
• Diagnostic challenges were noted due to the non-specific nature of the initial symptoms.
• Successful management of the retroperitoneal abscess required prompt recognition and intervention.

Implications:

• This case underscores the importance of considering deep-seated infections in intravenous drug users presenting with vague symptoms.
• Early recognition and appropriate imaging are crucial for timely diagnosis and treatment of retroperitoneal abscesses.
• Awareness of this complication can guide clinicians in managing at-risk populations and preventing severe outcomes.