Anatomical distribution of soft tissue sepsis sites in intravenous drug misusers attending an accident and emergency department.

Of 77,686 case records of attendance at an accident and emergency department during 1986, 488 (0.6%) contained documented evidence of intravenous drug misuse (IDM). Clinical examination had revealed signs of soft tissue sepsis in 150 (31%) of these, the commonest sites being the wrist and forearm (31% of lesions), the antecubital fossa (19%), fingers and hand (14%) and thigh and groin (11%). These data highlight the anatomical areas to which medical and nursing staff should pay particular attention when examining patients with a background of IDM. Conversely, the presentation of soft tissue sepsis in these sites should alert clinicians to the possibility of underlying IDM.