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Essentials of Diagnosis
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General Considerations
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Very common among persons who inject drugs habitually
Transmissible both by the parenteral (hepatitis B, C, and D) and by the fecal–oral route (hepatitis A)
Multiple episodes of hepatitis with different agents can occur
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Pulmonary Septic Emboli
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Sexually Transmitted Diseases
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Related to the practice of exchanging sex for drugs
Syphilis, gonorrhea, and chancroid are the most common
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Infective Endocarditis
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Other Vascular Infections
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Osteomyelitis and Septic Arthritis
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Osteomyelitis usually results from hematogenous distribution of injected organisms or septic venous thrombi
While staphylococci—often methicillin-resistant—are common organisms, also found are Serratia, Pseudomonas, Candida (often not C albicans), and other pathogens rarely encountered in spontaneous bone or joint disease
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> 2 million persons in North America are estimated to have used injection drugs in the past year
Opioid deaths increased during the COVID-19 pandemic, particularly in low-income urban neighborhoods
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