This case highlights bilateral upper extremity edema of a non-infectious cause due to lymphatic sclerosis after injection of intravenous drugs. This is a chronic condition that is treated by cessation of intravenous drug use and lymphedema specialists. The chronic edema may not improve after cessation of intravenous drug use. Although this is not a primary infectious process it has been recommended to treat for cellulitis to prevent a fascial space infection.
Johnson-Martinez, Krysta; Dustin Hillerson; and Peggy Beeley. "Clinical vignette: Puffy hand syndrome: a complication of arterial injection of illicit drugs resulting in chronic limb edema." (2014). https://digitalrepository.unm.edu/hostpitalmed_pubs/19