Delay in Diagnosing Spinal Infections Common with IV Drug Users

Posted by Thomas & Wickenheiser on Mar 19, 2020 7:15:00 AM

ER_800x533The recent alarming increase in IV drug use has also resulted in an increase in serious infections. An infection may arise when germs that reside on the skin or on a contaminated needle are pushed through the skin deeper into the body bypassing the normal barriers of entry or skin defenses. A common resulting infection seen in IV drug users are spinal epidural abscesses.

A spinal epidural abscess consists of a pocket of infected material that develops in the dural space, that is the space between the outer covering of the spinal cord and the spine. This infected pocket often presses against a spinal nerve or the spinal cord itself resulting in severe pain and neurological symptoms such as being unable to walk or having difficulty walking. Spinal epidural abscesses are typically located in the middle (thoracic) and lower (lumbar) back. A spinal epidural abscess is a medical emergency requiring early medical and surgical intervention to prevent devastating and permanent neurological effects such as paralysis, bowel/bladder incontinence, and even death.

Unfortunately, and a much more common experience than expected, when an IV drug user presents to the emergency room and reports severe pain and difficulty walking, he/she is often viewed through the lens of their drug use and are dismissed as “drug-seeking” rather than as a patient with symptoms of a potentially serious condition. Despite spinal epidural abscesses being a known medical complication in IV drug users, medical professionals, many of whom are unaware  or jaded by their own implicit care bias, simply engage in a quick triage and assessment and discharge these patients without a proper medical work-up.

Since timely diagnosis and surgery to remove the abscess is critical, by the time the patient gets proper testing and evaluation, usually on the the second or third hospital visit with worsening symptoms, permanent and irreversible damage has occurred. It is not uncommon for these patients to suffer paralysis requiring a wheelchair and permanent issues with their bowels and bladder requiring adult diapers.

If you have a loved one that is an IV drug user, understanding the risk of infection including spinal abscesses can help you be a more effective advocate. Be alert to symptoms such as severe back pain and difficulty walking. Urge your loved one to be clear in communicating what he/she is experiencing and to prioritize finding the source of the symptoms over requesting opioids for pain relief. If you can, be with them to help advocate for a complete medical evaluation.

If you or your loved one has experienced significant complications from a delay in diagnosing and treating an infection, consider speaking to an experienced medical malpractice attorney.

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