Shooter’s Abscess: Foot Infections in People Who Inject Drugs

Musculoskeletal infections are common among people who inject drugs. Little is known about the prevalence and characteristics of skin and soft-tissue infections in this patient population, especially in the lower extremity. The aim of this study is to describe the clinical characteristics, bacterial pathogens, and clinical outcomes in adults with foot infections due to intravenous drug use. Nine patients for whom the podiatric service was consulted for lower-extremity abscess secondary to intravenous drug use were included in this study. Most infections (66.7%) were located on the dorsal foot. Two of the abscesses (22.2%) resulted in amputation, with one toe amputation and one ray amputation. Most infections grew methicillin-resistant Staphylococcus aureus (MRSA) (66.7%). Although our investigation had limitations, we conclude that it is likely people who inject drugs will present with infections due to MRSA and will require surgery to resolve the infection.