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The Centers for Disease Control and Prevention recently reported that a substantial number of drug misusers in the US are injecting crack-cocaine instead of smoking it,1 owing to the decreased availability and increased cost of powdered cocaine. The use of lemon juice to dissolve crack-cocaine has been shown to cause abscesses, permanent vein damage and infections.2 Furthermore, heroin dissolved in preserved lemon juice was documented to be a source of Candidaalbicans in multiple, small epidemics of fungal endophthalmitis in the 1980s in the UK and Australia.3,4 We report here two recent cases of fungal endophthalmitis in crack users who similarly disclose dissolving crack-cocaine in lemon juice injection.
A 34-year-old male intravenous drug user presented to his primary care physician with high fever …
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