Ausgedehnte bilaterale Unterschenkelmuskelnekrosen nach nasaler Heroinapplikation : Makroskopische und histologische Befunde bei einem 23-jährigen Mann (Fallbericht)

Rhabdomyolysis is one of the less known complications of heroin abuse. A case of lower leg muscle necrosis after nasal application of heroin is reported with repeated resection of the necrotic muscles. Superinfection with a methicillin-resistent Staphylococcus aureus (MRSA) strain was present. After 4 weeks, bilateral amputation could not be avoided. We regard a direct toxic effect of the heroin as the most probable mechanism of the muscular damage, with possible influence of the reduced oxygen delivery due to central respiratory and circulatory depression.