Presentation
Long history of marijuana use
Patient Data



Tracheostomy in situ. Opacities in the right mid and lower zones likely represent scarring post infection. No focal consolidative changes. No pleural effusion. Right apical bullae noted.
No pneumothorax or subdiaphragmatic free gas. Cardiomediastinal contour is normal.
The diffuse emphysematous changes in both lungs are very suspicious for changes of marijuana inhalation.

There are extensive bullous changes in both upper lobes. Infective changes are noted in the right lower lobe.
Case Discussion
The possibility of marijuana inhalation needs to be considered when large bullae are present in the upper zones in a young male patient.