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01st Feb 2022

Man suffers penile necrosis after injecting cocaine into his penis

Charlie Herbert

Man suffers penile necrosis after injecting cocaine in his penis

Whilst searching for an injection spot, the man chose the dorsal vein in his penis

Doctors in the US have reported how a man suffered penile necrosis after injecting cocaine into his penis.

The case appeared in the American Journal of Case Reports, and explains how the 35-year-old Hispanic man showed up at hospital following three days of “excruciating and progressive penile and scrotal pain after having injected cocaine in the dorsal vein of the penis.”

Upon inspecting the man, doctors found that he had a swelling of the penis, as well as necrosis – aka the death of tissue – ulcers along the shaft and foul-smelling discharge.

Both gangrene and any sexually transmitted infections were ruled out and the main was given antibiotics and had his wounds treated.

Doctors were considering cutting away the dead tissue on the penis – but the man refused this.

After 15 days, the wounds eventually improved and the infection was contained.

During his stay at the hospital, the man explained how he had a long history of intravenous drug use which meant he had damaged other injections spots, causing him to resort to the dorsal vein in his penis.

He had used the vein twice but after the third injection he experienced immediate pain.

In the case report, the doctors note that 80 per cent of cocaine in the US is laced with levamisole. This is a medication used to treat parasitic worm infections but which is cut into cocaine to increase profits and enhance the high of the drug.

However the drug is associated with the development of inflammation of the blood vessel walls as well as necrotic lesions. This may have been what contributed to the extreme damage done to the man’s penis.

Doctors concluded that the case “highlights the importance of taking a thorough history from i.v. drug users, as they are at risk of injecting drugs into unusual sites, such as the dorsal penile vein,” and emphasised the importance of drug users being made aware of the “possible complications of injecting drugs in atypical and dangerous injection sites.”

They added that the only long-term solution would be for the man to stop using cocaine, so counseling and drug rehabilitation programs were recommended to him.

However after being discharged from hospital, the man refused drug rehabilitation and was later lost to follow-up.

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