IMAGES IN EMERGENCY MEDICINE
Necrotising myositis after intravenous methylphenidat (Ritalin) injection
Department of Orthopaedic and Trauma Surgery, Royal Perth Hospital, Perth, WA, Australia
Correspondence to:
Correspondence to:
Dr Oliver P Gautschi
Royal Perth Hospital, Department of Orthopaedic and Trauma Surgery, North Block, Level 5, Wellington Street, Perth 6000, WA, Australia; ogautschi@datacomm.ch
Keywords: abscess; intravenous drug user; methylphenidat; necrotising myositis; Ritalin
| The first 150 words of the full text of this article appear below. |
A 30 year old male intravenous drug user was admitted with a swollen painful left thigh after injection of 30 mg methylphenidat (Ritalin). On examination, we found a softball-sized abscess in his left thigh. Striking lab results were a CK of 18 100 U/l, a CRP of 177 mg/l, and a WCC of 20.0x109/l. A CT scan revealed a large abscess that contained multiple pockets of gas, extending from the lesser trochanter to the distal femoral condyle (fig 1
). The patient went to theatre and the abscess was excised and drained and an extensive debridement was performed. Macro- and microscopic analysis showed acute necrotising myositis and extensive abscess formation. The patient was re-examined 2 days later and the wound was closed. Thereafter, healing of the wound progressed well. The patient was discharged home 15 days postoperatively.
[in a new window] Figure 1 CT scans showing a large abscess.
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Competing interests: none declared
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