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doi: 10.1111/j.1600-0749.2005.00281.x [DOI] [PubMed] [Google Scholar] 15.Kim S.J., Han D., Ahn B.H., Rhee J.S.1997

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Injecting contaminated solution introduces these organisms directly into subcutaneous tissue, potentially causing: Localized injection site reactions (redness, swelling, warmth) Abscess formation requiring medical drainage Cellulitis (spreading skin infection) In rare cases, systemic infection The risk is highest for vials that are significantly past their BUD, have been stored improperly, or have been punctured many times