Complications of heroin injections of the neck.

The purpose of this paper is to emphasize the importance of heroin injections in the neck as an etiology of superficial and deep neck infections and to familiarize the otolaryngologist with the problems in the diagnosis and management of such infections. This study represents the first series to be reported in the world literature of patients with neck infections secondary to heroin injections. Fifty-seven patients with neck infections related to injection of heroin in the neck (main-lining) were studied. These patients were admitted to Detroit General Hospital during the three-year period between January 1974 and December 1976. The clinical signs and symptoms, location of the abscesses, soft tissue radiographs of the neck, arteriograms and ultrasound examinations of the neck are discussed. The diagnostic evaluation and the treatment of the heroin addict who presents with an inflammatory neck mass are outlined, emphasizing the difficulty and the importance of differentiating between cellulitis, abscess, and pseudoaneurysms of the carotid and subclavian arteries.