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Crack Lung: Cocaine induced lung injury

Article  in  QJM: monthly journal of the Association of Physicians · March 2015

DOI: 10.1093/qjmed/hcv064 · Source: PubMed

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Rushikesh Shah Arpan Patel

Emory University State University of New York Upstate Medical University
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Omar Mousa Divey Manocha

State University of New York Upstate Medical University State University of New York Upstate Medical University
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 QJM Advance Access published April 13, 2015

QJM: An International Journal of Medicine, 2015, 1

doi: 10.1093/qjmed/hcv064
Advance Access Publication Date: 14 March 2015
Clinical Picture

CLINICAL PICTURE

Crack lung: cocaine-induced lung injury

A 31-year-old female presented with acute onset shortness of cocaine. The management is supportive with maintaining oxy-
breath and chest pain. She had a past medical history of co- genation with O2 supplementation. Cocaine-induced pulmon-
caine abuse and agreed that she used cocaine 2 days prior to ary embolism although rare has been reported previously.
presentation. On admission, her vitals included Blood Pressure Underlying mechanism is believed to be stasis in pulmonary
of 160/70, Heart Rate—110, Respiratory Rate—36 with oxygen circulation leading to in situ thrombosis.
saturation of 78%. Chest X-ray showed some interstitial opac-
ities. CT scan of the chest was performed, which revealed dif-
Photographs and text from: R. Shah, SUNY Upstate Medical
fuse ground glass opacity consistent with cocaine-induced
University, 50 Presidential Plaza, Syracuse, NY 13202, USA;
lung injury—crack lung (Figure 1A) as well as cocaine-induced
A. Patel, SUNY Upstate Medical University, 153 Summerheaven
in situ thrombosis (Figure 1B). She was treated with anticoagu-
drive, East Syracuse, NY 13057, USA; O. Mousa and D. Manocha,
lation and supportive measures including oxygen. She was fi-
SUNY Upstate Medical University, 750 E Adams Street, Syracuse,
nally discharged home on Coumadin as well as continues

Downloaded from by guest on August 22, 2015

NY 13210, USA. email: rushishah.17@gmail.com.
home oxygen. Crack lung occurs due to diffuse alveolar dam-
age and alveolar hemorrhage that occurs 48 h after smoking Conflict of Interest: None declared.

Figure 1. A. Cocaine-induced diffuse alveolar hemorrhage. B. Cocaine-induced in situ lung thrombosis (shown by arrow).

C The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians.
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