Multiple Retained Needles in the Neck of a Drug User: A Case Report.
Mohamed El Mehdi Bouzid, Makram Tbini, Mariam Ben Ayed et al.
✦ AI-curated · Sources linked
Case in brief
A 43-year-old man with HIV, hepatitis C, and a history of repetitive intravenous drug use presented with three days of fever and a tender, 8 cm lateral neck swelling with torticollis. CT showed sternocleidomastoid myositis with an abscess, multiple metallic objects consistent with broken needles, and ipsilateral jugular vein thrombosis; no central foreign-body embolism was seen. Surgical drainage yielded a 1 cm needle from the collection. The other needles were left in place because they were asymptomatic. Intravenous antibiotics followed by oral amoxicillin-clavulanate led to regression of the cellulitis, and the remaining foreign bodies stayed asymptomatic at follow-up.
What made this case unusual
Multiple retained neck needles were discovered alongside a sternocleidomastoid abscess and ipsilateral jugular vein thrombosis, while the other needles remained asymptomatic and were not retrieved.
Diagnostic / clinical pearl
In people with a history of intravenous drug use and a neck infection, consider retained needle fragments; imaging can identify their location and associated complications.
Why it matters
Recognizing retained fragments can inform management of complications and help protect healthcare staff from accidental needle injuries.